Provider Demographics
NPI:1962892901
Name:KIDDSMILES II PLLC
Entity type:Organization
Organization Name:KIDDSMILES II PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-576-4254
Mailing Address - Street 1:1201 NORTHERN BLVD
Mailing Address - Street 2:STE 102
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3037
Mailing Address - Country:US
Mailing Address - Phone:516-365-5439
Mailing Address - Fax:516-365-5469
Practice Address - Street 1:1201 NORTHERN BLVD
Practice Address - Street 2:STE 102
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3037
Practice Address - Country:US
Practice Address - Phone:516-365-5439
Practice Address - Fax:516-365-5469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty