Healthcare Provider Details

I. General information

NPI: 1376456012
Provider Name (Legal Business Name): SMILE WITH CONFIDENCE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 NW 12TH ST
POMPANO BEACH FL
33060-6097
US

IV. Provider business mailing address

101 NW 12TH ST
POMPANO BEACH FL
33060-6097
US

V. Phone/Fax

Practice location:
  • Phone: 775-418-4017
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: BELANNE ESTIME
Title or Position: OWNER
Credential:
Phone: 775-418-4017