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NPI Code Detail

MEDICARE: SMILE PERFECT INC.

MEDICARE: SMILE PERFECT INC.
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
1122300000XDentistFL9534FL

General Provider Information

NPI Number : 1851395883
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMILE PERFECT INC.
Provider Business Mailing Address
First Line : 915 MIDDLE RIVER DR
Second Line : STE 501
City : FT LAUDERDALE
State : FL
Zip : 33304-3561
Country : US
Telephone Number : 954-566-0751
Fax Number : 954-566-1674
Provider Business Practice Location Address
First Line : 915 MIDDLE RIVER DR
Second Line : STE 501
City : FT LAUDERDALE
State : FL
Zip : 33304-3561
Country : US
Telephone Number : 954-566-0751
Fax Number : 954-566-1674
Authorized Official
Title or Position : OWNER/DENTIST/PRESIDENT
Name : DR. WILLIAM L BALANOFF
Credential : DDS
Telephone Number : 954-566-0754
Provider Enumeration Date : 06/08/2005
Last Update Date : 08/22/2020

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Directions to “SMILE PERFECT INC. ” Practice Location

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