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General NPI Number Information
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NPI Number | 1184072993
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Entity Type | Organization
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Legal Business Name | SMILOW FAMILY DENTISTRY PC
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 06/10/2016
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Provider Practice Location Address
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Address Line | 41 MOUNTAIN AVE
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-1718
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Country | US
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Telephone | 973-379-2202
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Fax | 973-376-1566
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Provider Business Mailing Address
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Address Line | 41 MOUNTAIN AVE
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-1718
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Country | US
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Telephone | 973-379-2202
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Fax | 973-376-1566
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Authorized Official
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Title or Position | OWNER
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Name | JOSHUA SMILOW
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Credential | D.M.D.
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Telephone | 516-641-5113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DI02434600
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License Number State | NJ
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