Provider Demographics
NPI:1043490717
Name:DENTISTRY WITH A SMILE, LLC
Entity Type:Organization
Organization Name:DENTISTRY WITH A SMILE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUHAIR
Authorized Official - Middle Name:ADEL
Authorized Official - Last Name:SHAMOON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-672-6471
Mailing Address - Street 1:920 PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-1944
Mailing Address - Country:US
Mailing Address - Phone:508-672-6471
Mailing Address - Fax:
Practice Address - Street 1:920 PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-1944
Practice Address - Country:US
Practice Address - Phone:508-672-6471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20210122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty