33D2205361 CLIA NUMBER - THOMAS VIGLIANTE DDS NORTH COUNTRY DENTAL CARE

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Laboratory Demographics

CLIA Number: 33D2205361

Facility Name: THOMAS VIGLIANTE DDS NORTH COUNTRY DENTAL CARE

Facility Address:
436 NORTH COUNTRY ROAD
ST JAMES, NY
ZIP 11780
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Facility Phone Number: 631 584-5605

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1487007050

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	33D2205361
LAB Type	Physician Office
Facility Name	THOMAS VIGLIANTE DDS NORTH COUNTRY DENTAL CARE
Street	436 NORTH COUNTRY ROAD
City	ST JAMES
State	NY
ZIP	11780
Phone	631 584-5605
CertificateType	4
CertificateEffectiveDate	12/14/2022
CertificateExpirationDate	12/13/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024