Provider Demographics
NPI:1033301114
Name:ALL SMILES DENTISTRY
Entity Type:Organization
Organization Name:ALL SMILES DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACKLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MADURO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-267-0270
Mailing Address - Street 1:10 PINE ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-4167
Mailing Address - Country:US
Mailing Address - Phone:973-267-0270
Mailing Address - Fax:973-267-9274
Practice Address - Street 1:10 PINE ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-4167
Practice Address - Country:US
Practice Address - Phone:973-267-0270
Practice Address - Fax:973-267-9274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI022635001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty