Provider Demographics
NPI:1841849965
Name:WOODROW LITTLE SMILES FAMILY DENTISTRY P.C.
Entity type:Organization
Organization Name:WOODROW LITTLE SMILES FAMILY DENTISTRY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:CORBETT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:718-317-8524
Mailing Address - Street 1:7001 AMBOY ROAD SUITE #113
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307
Mailing Address - Country:US
Mailing Address - Phone:718-317-8524
Mailing Address - Fax:347-507-2245
Practice Address - Street 1:739 WOODROW ROAD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312
Practice Address - Country:US
Practice Address - Phone:718-317-8524
Practice Address - Fax:347-507-2245
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOODROW LITTLE SMILES FAMILY DENTISTRY P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty