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General NPI Number Information
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NPI Number | 1184276990
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Entity Type | Organization
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Legal Business Name | ABC FAMILY SMILES LLC
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 252 MADISON AVE STE 106
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City | PERTH AMBOY
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State | NJ
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Zip | 08861-4314
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Country | US
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Telephone | 732-991-6453
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Fax |
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Provider Business Mailing Address
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Address Line | 252 MADISON AVE STE 106
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City | PERTH AMBOY
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State | NJ
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Zip | 08861-4314
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Country | US
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Telephone | 732-991-6453
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. HARIL PATEL
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Credential |
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Telephone | 732-648-7585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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