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General NPI Number Information
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NPI Number | 1477791853
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE SMILE DESIGN, PA
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Dates
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Enumeration Date | 01/23/2009
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Last Update Date | 01/23/2009
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Provider Practice Location Address
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Address Line | 225 S FEDERAL HWY
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City | LAKE WORTH
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State | FL
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Zip | 33460-4230
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Country | US
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Telephone | 561-582-1911
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Fax |
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Provider Business Mailing Address
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Address Line | 225 S FEDERAL HWY
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City | LAKE WORTH
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State | FL
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Zip | 33460-4230
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Country | US
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Telephone | 561-582-1911
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Fax |
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Authorized Official
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Title or Position | VP
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Name | DR. MANOJ K PATEL
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Credential | D.D.S
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Telephone | 561-582-1911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN12943
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN15871
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License Number State | FL
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