Provider Demographics
NPI:1841962701
Name:CARLETTO DENTAL
Entity type:Organization
Organization Name:CARLETTO DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARYANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLETTO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-321-1418
Mailing Address - Street 1:982 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-6110
Mailing Address - Country:US
Mailing Address - Phone:631-321-1418
Mailing Address - Fax:631-321-0136
Practice Address - Street 1:982 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-6110
Practice Address - Country:US
Practice Address - Phone:631-321-1418
Practice Address - Fax:631-321-0136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty