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General NPI Number Information
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NPI Number | 1376123182
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Entity Type | Organization
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Legal Business Name | SMILES 4 DURHAM INC
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Dates
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Enumeration Date | 04/14/2021
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 370 JACKSON ST
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City | DURHAM
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State | NC
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Zip | 27701
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Country | US
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Telephone | 919-569-5533
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Fax |
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Provider Business Mailing Address
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Address Line | 370 JACKSON ST
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City | DURHAM
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State | NC
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Zip | 27701-1192
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Country | US
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Telephone | 919-569-5533
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MAHMOUD SERAG
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Credential | DDS
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Telephone | 919-569-5533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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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 | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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