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General NPI Number Information
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NPI Number | 1770243354
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Entity Type | Organization
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Legal Business Name | SIMPLE SMILE DENTAL CARE LLC
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Dates
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Enumeration Date | 12/23/2021
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 2200 NJ-10 SUITE 105
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City | PARSIPPANY
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State | NJ
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Zip | 07054
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Country | US
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Telephone | 973-370-5221
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Fax |
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Provider Business Mailing Address
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Address Line | 2711 HICKORY RD
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City | UNION
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State | NJ
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Zip | 07083-6429
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Country | US
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Telephone | 201-580-1527
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHEREN ELSAID
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Credential | DMD
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Telephone | 201-580-1527
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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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