Healthcare Provider Details

I. General information

NPI: 1619886058
Provider Name (Legal Business Name): SMILE CULTURE WAYNE PPLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 E SWEDESFORD RD
WAYNE PA
19087
US

IV. Provider business mailing address

520 S OXFORD VALLEY RD
FAIRLESS HILLS PA
19030-2615
US

V. Phone/Fax

Practice location:
  • Phone: 215-946-3655
  • Fax:
Mailing address:
  • Phone: 484-800-8444
  • 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: ALLISON TEIXEIRA
Title or Position: RCM SUPERVISOR
Credential:
Phone: 484-800-8444