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General NPI Number Information
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NPI Number | 1811319445
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Entity Type | Organization
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Legal Business Name | ALL SMILES DENTAL GROUP INC
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Dates
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Enumeration Date | 01/16/2014
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Last Update Date | 01/16/2014
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Provider Practice Location Address
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Address Line | 420 N BLACK HORSE PIKE
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-1439
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Country | US
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Telephone | 856-740-1416
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Fax | 856-740-2513
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Provider Business Mailing Address
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Address Line | 420 N BLACK HORSE PIKE
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-1439
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Country | US
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Telephone | 856-740-1416
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Fax | 856-740-2513
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | NERMEEN RIFAI
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Credential | DMD
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Telephone | 856-740-1416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02473000
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License Number State | NJ
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