Provider Demographics
NPI:1417260167
Name:DR. LAUREN S. ARGENTINA, DDS, PC
Entity Type:Organization
Organization Name:DR. LAUREN S. ARGENTINA, DDS, PC
Other - Org Name:MODERN DENTISTRY OF LONG ISLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ARGENTINA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-473-0582
Mailing Address - Street 1:714 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-2223
Mailing Address - Country:US
Mailing Address - Phone:631-473-0582
Mailing Address - Fax:631-473-3525
Practice Address - Street 1:714 MAIN ST
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-2223
Practice Address - Country:US
Practice Address - Phone:631-473-0582
Practice Address - Fax:631-473-3525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0523161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty