Individual provider · Type 1 NPI
Shady Samuel
Pediatric Dentistry · Mineola, NY
NPI number
1245536382
Active
Practice location
18 Jerome Ave
Mineola, NY 11501-3302
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Dentistry Primary | 1223P0221X | 055773 (NY) |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
About NPI 1245536382
Shady Samuel's National Provider Identifier is 1245536382, issued on Feb 8, 2011. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Mineola, NY. The record was last updated on Aug 15, 2017.