Provider Demographics
NPI:1043895808
Name:UR SMILE DENTAL
Entity Type:Organization
Organization Name:UR SMILE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANPREET
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-877-6453
Mailing Address - Street 1:201 ELDEN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4812
Mailing Address - Country:US
Mailing Address - Phone:571-877-6453
Mailing Address - Fax:571-466-2783
Practice Address - Street 1:201 ELDEN ST STE 102
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4812
Practice Address - Country:US
Practice Address - Phone:571-877-6453
Practice Address - Fax:571-466-2783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-13
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty