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General NPI Number Information
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NPI Number | 1811398464
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Entity Type | Organization
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Legal Business Name | SMILE PLUS DENTISTRY LLC
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Dates
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Enumeration Date | 09/12/2014
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Last Update Date | 09/12/2014
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Provider Practice Location Address
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Address Line | 880 POPLAR CHURCH RD
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City | CAMP HILL
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State | PA
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Zip | 17011-2205
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Country | US
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Telephone | 717-307-8023
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Fax | 717-238-5336
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Provider Business Mailing Address
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Address Line | 880 POPLAR CHURCH RD
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City | CAMP HILL
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State | PA
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Zip | 17011-2205
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Country | US
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Telephone | 717-307-8023
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Fax | 717-238-5336
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Authorized Official
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Title or Position | PRESIDENT
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Name | RENUKA Y PARIKH
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Credential |
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Telephone | 717-307-8023
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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 | DS039837
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License Number State | PA
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