MEDICARE: SMILE DENTAL CARE P.C

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	122300000X	Dentist

General Provider Information

NPI Number	:	1891499745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMILE DENTAL CARE P.C

Provider Business Mailing Address
First Line	:	586 MORRIS AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-5172
Country	:	US
Telephone Number	:	646-401-7878
Fax Number	:

Provider Business Practice Location Address
First Line	:	2344 EASTCHESTER RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-5911
Country	:	US
Telephone Number	:	646-401-7878
Fax Number	:

Authorized Official
Title or Position	:	MANAGEMENT
Name	:	MR. RUSHIN GANDHI
Credential	:
Telephone Number	:	917-703-1985

Provider Enumeration Date	:	03/27/2023
Last Update Date	:	03/27/2023

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