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General NPI Number Information
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NPI Number | 1194326843
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Entity Type | Organization
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Legal Business Name | STELLAR SMILES INC.
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Dates
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Enumeration Date | 11/07/2020
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 9070 KIMBERLY BLVD STE 51
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City | BOCA RATON
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State | FL
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Zip | 33434-2861
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Country | US
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Telephone | 561-990-2934
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 AUDACE AVE APT 311
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-3354
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Country | US
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Telephone | 646-894-1098
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. EMMANUELLY MORALES
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Credential | DDS
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Telephone | 646-894-1098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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