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General NPI Number Information
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NPI Number | 1902157910
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Entity Type | Organization
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Legal Business Name | PERFECT SMILE BRACES, P.C.
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Dates
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Enumeration Date | 10/01/2012
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 555 E FORDHAM RD
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City | BRONX
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State | NY
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Zip | 10458-5046
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Country | US
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Telephone | 347-801-8888
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Fax | 347-801-8888
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Provider Business Mailing Address
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Address Line | 555 E FORDHAM RD
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City | BRONX
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State | NY
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Zip | 10458-5046
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Country | US
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Telephone | 347-801-8888
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Fax | 347-801-8888
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | EMIL BAILEY
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Credential | DMD, MS
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Telephone | 347-801-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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