MEDICARE: SMILES FOREVER FAMILY DENTISTRY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1164936670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMILES FOREVER FAMILY DENTISTRY PLLC

Provider Business Mailing Address
First Line	:	777 PINE VALLEY DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15239-2842
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 PINE VALLEY DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15239-2842
Country	:	US
Telephone Number	:	412-478-4251
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. GAGANDEEP SINGH SANDHU
Credential	:	DDS
Telephone Number	:	412-478-4251

Provider Enumeration Date	:	11/20/2017
Last Update Date	:	03/17/2018

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