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General NPI Number Information
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NPI Number | 1740385780
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Entity Type | Organization
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Legal Business Name | THE SMILEPLACE FAMILY DENTISTRY
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 594 E MAIN ST
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City | MIDDLETOWN
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State | NY
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Zip | 10940-2632
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Country | US
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Telephone | 845-342-2125
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Fax | 845-342-1727
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Provider Business Mailing Address
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Address Line | 594 E MAIN ST
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City | MIDDLETOWN
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State | NY
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Zip | 10940-2632
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Country | US
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Telephone | 845-342-2125
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Fax | 845-342-1727
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Authorized Official
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Title or Position | PARTNER
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Name | DR. BRUCE WEINER
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Credential | DDS
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Telephone | 845-342-2125
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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 |
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License Number State |
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