Provider Demographics
NPI:1083725667
Name:SMILE ZONE PC
Entity Type:Organization
Organization Name:SMILE ZONE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RACHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAJAJ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-835-1280
Mailing Address - Street 1:38 RAMAPO AVENUE
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442
Mailing Address - Country:US
Mailing Address - Phone:973-835-1280
Mailing Address - Fax:973-839-2989
Practice Address - Street 1:38 RAMAPO AVENUE
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442
Practice Address - Country:US
Practice Address - Phone:973-835-1280
Practice Address - Fax:973-839-2989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI21875122300000X
NJ1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty