Provider Demographics
NPI:1275600165
Name:ERNEST P LARIOS DDS PC
Entity Type:Organization
Organization Name:ERNEST P LARIOS DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:P
Authorized Official - Last Name:LARIOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-689-3800
Mailing Address - Street 1:14 MILLSTREAM LANE
Mailing Address - Street 2:
Mailing Address - City:STONYBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790
Mailing Address - Country:US
Mailing Address - Phone:631-689-3800
Mailing Address - Fax:631-689-3800
Practice Address - Street 1:14 MILLSTREAM LANE
Practice Address - Street 2:
Practice Address - City:STONYBROOK
Practice Address - State:NY
Practice Address - Zip Code:11790
Practice Address - Country:US
Practice Address - Phone:631-689-3800
Practice Address - Fax:631-689-3800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty