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General NPI Number Information
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NPI Number | 1699573592
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Entity Type | Organization
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Legal Business Name | WARSAW SMILE DENTAL INC.
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 5671 RICHMOND RD
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City | WARSAW
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State | VA
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Zip | 22572-4355
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Country | US
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Telephone | 804-333-4054
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Fax |
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Provider Business Mailing Address
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Address Line | 4218 HIDDENWELL LN
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City | CHESTER
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State | VA
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Zip | 23831-6969
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Country | US
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Telephone | 630-313-9137
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | JILESH GANDHI
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Credential |
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Telephone | 630-313-9137
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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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