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General NPI Number Information
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NPI Number | 1356943955
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Entity Type | Organization
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Legal Business Name | SMILE DESIGNS 101
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Dates
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Enumeration Date | 11/10/2020
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Last Update Date | 11/17/2020
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Provider Practice Location Address
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Address Line | 900 EASTON AVE
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City | SOMERSET
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State | NJ
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Zip | 08873-1760
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Country | US
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Telephone | 732-247-7417
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Fax | 732-828-7729
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Provider Business Mailing Address
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Address Line | 900 EASTON AVE
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City | SOMERSET
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State | NJ
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Zip | 08873-1760
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Country | US
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Telephone | 732-247-7417
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Fax | 732-828-7729
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Authorized Official
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Title or Position | MANAGER
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Name | JENNFER RAPOSO
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Credential |
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Telephone | 732-247-7417
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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 |
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License Number State |
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