Provider Demographics
NPI:1841645355
Name:NORTH SHORE ENDODONTIC SOLUTIONS
Entity type:Organization
Organization Name:NORTH SHORE ENDODONTIC SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAMIA
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:631-474-3636
Mailing Address - Street 1:125 OAKLAND AVE
Mailing Address - Street 2:#104
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-2130
Mailing Address - Country:US
Mailing Address - Phone:631-474-3636
Mailing Address - Fax:631-474-3635
Practice Address - Street 1:125 OAKLAND AVE
Practice Address - Street 2:#104
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-2130
Practice Address - Country:US
Practice Address - Phone:631-474-3636
Practice Address - Fax:631-474-3635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental