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General NPI Number Information
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NPI Number | 1457678062
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Entity Type | Organization
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Legal Business Name | SMILE DESIGNS INC
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | 95 WASHINGTON ST # 480 SMILE DESIGNS INC
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City | CANTON
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State | MA
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Zip | 02021
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Country | US
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Telephone | 781-828-1090
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Fax |
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Provider Business Mailing Address
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Address Line | 95 WASHINGTON ST # 480 SMILE DESIGNS INC
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City | CANTON
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State | MA
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Zip | 02021
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Country | US
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Telephone | 781-828-1090
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHABANA CHAUDHRY
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Credential | DMD
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Telephone | 781-828-1090
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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 | 19564
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License Number State | MA
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