Organization · Type 2 NPI
Roosevelt Field Mall Dental PC
Periodontics · Garden City, NY
NPI number
1073638151
Active
Practice location
630 Old Country Road
Garden City, NY 11530
Fax (516) 294-6219
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Dentistry | 1223G0001X | None listed |
| Periodontics Primary | 1223P0300X | None listed |
Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
About NPI 1073638151
Roosevelt Field Mall Dental PC's National Provider Identifier is 1073638151, issued on Mar 20, 2007. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Garden City, NY. The record was last updated on Sep 11, 2025.