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General NPI Number Information
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NPI Number | 1609669654
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Entity Type | Organization
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Legal Business Name | SMILE HAVEN DENTAL PLLC
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 4 BIRCH ST UNIT 104
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City | DERRY
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State | NH
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Zip | 03038-2136
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Country | US
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Telephone | 603-434-4090
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Fax |
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Provider Business Mailing Address
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Address Line | 210 LINDSTROM LN
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City | MANCHESTER
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State | NH
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Zip | 03104-4792
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Country | US
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Telephone | 603-858-7290
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROHAN PATEL
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Credential | DMD
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Telephone | 603-858-7290
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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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