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General NPI Number Information
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NPI Number | 1952865933
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Entity Type | Organization
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Legal Business Name | NUSMILE DENTAL LLC
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Dates
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Enumeration Date | 01/24/2019
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Last Update Date | 01/24/2019
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Provider Practice Location Address
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Address Line | 10107 VERREE RD
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City | PHILADELPHIA
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State | PA
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Zip | 19116-3613
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Country | US
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Telephone | 267-388-7754
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Fax |
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Provider Business Mailing Address
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Address Line | 10107 VERREE RD
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City | PHILADELPHIA
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State | PA
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Zip | 19116-3613
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Country | US
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Telephone | 267-388-7754
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Fax |
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Authorized Official
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Title or Position | BUISNESS OWNER
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Name | VIJI SEETHRAMAN
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Credential | DDS
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Telephone | 732-666-7415
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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 |
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License Number State |
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