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General NPI Number Information
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NPI Number | 1447527353
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Entity Type | Organization
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Legal Business Name | NEW SMILE DENTISTRY, PA
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Dates
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Enumeration Date | 11/20/2011
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Last Update Date | 11/20/2011
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Provider Practice Location Address
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Address Line | 620 W STATE ROAD 434
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-5330
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Country | US
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Telephone | 407-327-0731
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Fax | 407-327-1018
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Provider Business Mailing Address
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Address Line | 620 W STATE ROAD 434
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-5330
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Country | US
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Telephone | 407-327-0731
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Fax | 407-327-1018
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Authorized Official
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Title or Position | DENTIST-PRESIDENT
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Name | DR. FIRAS MAROUF
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Credential | DMD
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Telephone | 407-327-0731
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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 | DN17064
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License Number State | FL
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