Provider Demographics
NPI:1043756646
Name:OCEAN SMILES
Entity Type:Organization
Organization Name:OCEAN SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:STROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-421-8238
Mailing Address - Street 1:450 JACK MARTIN BLVD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-7779
Mailing Address - Country:US
Mailing Address - Phone:732-458-9700
Mailing Address - Fax:732-458-0237
Practice Address - Street 1:450 JACK MARTIN BLVD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7779
Practice Address - Country:US
Practice Address - Phone:732-458-9700
Practice Address - Fax:732-458-0237
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OCEAN SMILES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty