Provider Demographics
NPI:1083029508
Name:AESTHETIC SMILES OF NJ
Entity Type:Organization
Organization Name:AESTHETIC SMILES OF NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROMANO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-285-5480
Mailing Address - Street 1:310 MADISON AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6967
Mailing Address - Country:US
Mailing Address - Phone:973-285-5480
Mailing Address - Fax:973-285-0191
Practice Address - Street 1:310 MADISON AVE
Practice Address - Street 2:SUITE 210A
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6967
Practice Address - Country:US
Practice Address - Phone:973-285-5480
Practice Address - Fax:973-285-0191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI161381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty