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General NPI Number Information
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NPI Number | 1952229338
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Entity Type | Organization
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Legal Business Name | SMILES ON LEE PEDIATRIC DENTISTRY PLLC
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 124 LEE AVE
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City | BROOKLYN
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State | NY
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Zip | 11211-8270
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Country | US
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Telephone | 929-853-0910
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Fax |
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Provider Business Mailing Address
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Address Line | 124 LEE AVE
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City | BROOKLYN
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State | NY
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Zip | 11211-8270
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Country | US
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Telephone | 929-853-0910
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | SHALOM BLOBSTEIN
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Credential |
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Telephone | 929-853-0910
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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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