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General NPI Number Information
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NPI Number | 1336888726
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Entity Type | Organization
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Legal Business Name | MOUNT SMILES ORTHODONTICS
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 486 SCHOOLEYS MOUNTAIN RD STE 2A
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City | HACKETTSTOWN
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State | NJ
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Zip | 07840-4000
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Country | US
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Telephone | 774-301-6508
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Fax |
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Provider Business Mailing Address
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Address Line | 9 SPINNAKER DR
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City | BARRINGTON
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State | RI
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Zip | 02806-2831
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PRANALI PATEL
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Credential |
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Telephone | 774-301-6508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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