Healthcare Provider Details

I. General information

NPI: 1497644561
Provider Name (Legal Business Name): SMILETOWN DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1177 RINEHART RD
SANFORD FL
32771-7390
US

IV. Provider business mailing address

1177 RINEHART RD
SANFORD FL
32771-7390
US

V. Phone/Fax

Practice location:
  • Phone: 407-504-1992
  • Fax:
Mailing address:
  • Phone: 407-504-1992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. KARAN DOOMRA
Title or Position: ASSOCIATE
Credential: DDS
Phone: 407-504-1992