Healthcare Provider Details

I. General information

NPI: 1467369348
Provider Name (Legal Business Name): CLEO'S SMILES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W UNION BLVD UNIT 1
BETHLEHEM PA
18018-3732
US

IV. Provider business mailing address

701 W UNION BLVD UNIT 1
BETHLEHEM PA
18018-3732
US

V. Phone/Fax

Practice location:
  • Phone: 610-868-0833
  • Fax:
Mailing address:
  • Phone: 610-868-0833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: NARDINE BASTAWROS
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 610-868-0833