Provider Demographics
NPI:1124542584
Name:MOLAR TO MOLAR DENTISTRY PC
Entity Type:Organization
Organization Name:MOLAR TO MOLAR DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAIFALI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMETRA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-771-1577
Mailing Address - Street 1:1679 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-2406
Mailing Address - Country:US
Mailing Address - Phone:631-771-1577
Mailing Address - Fax:631-771-1570
Practice Address - Street 1:1679 NEW YORK AVENUE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746
Practice Address - Country:US
Practice Address - Phone:631-771-1577
Practice Address - Fax:631-771-1570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0544751223G0001X
1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty