Provider Demographics
NPI:1053859652
Name:SWEET TOOTH DENTAL
Entity Type:Organization
Organization Name:SWEET TOOTH DENTAL
Other - Org Name:EASE DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HASAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBAIYAA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-223-4226
Mailing Address - Street 1:3200 SCHREIBER PL
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510
Mailing Address - Country:US
Mailing Address - Phone:516-223-4226
Mailing Address - Fax:516-771-4515
Practice Address - Street 1:3200 SCHREIBER PL
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510
Practice Address - Country:US
Practice Address - Phone:516-223-4226
Practice Address - Fax:516-771-4515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057623122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty