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General NPI Number Information
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NPI Number | 1699246777
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Entity Type | Organization
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Legal Business Name | SMILE DESIGN DENTAL STUDIO PLLC
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 12/16/2018
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Provider Practice Location Address
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Address Line | 320 E 53RD ST STE 1A
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City | NEW YORK
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State | NY
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Zip | 10022-5298
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Country | US
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Telephone | 212-223-7946
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Fax | 212-223-7948
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Provider Business Mailing Address
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Address Line | 320 E 53RD ST STE 1A
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City | NEW YORK
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State | NY
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Zip | 10022-5298
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Country | US
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Telephone | 212-223-7946
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Fax | 212-223-7948
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Authorized Official
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Title or Position | DENTIST
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Name | DR. FRANKLYN OSAIGBOVO AGUEBOR
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Credential | DMD
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Telephone | 404-368-0668
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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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