Provider Demographics
NPI:1083820427
Name:SMILE CARE OF DENVILLE
Entity Type:Organization
Organization Name:SMILE CARE OF DENVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJAL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-366-6662
Mailing Address - Street 1:9 MOUNT PLEASANT TPKE
Mailing Address - Street 2:SUIT # 203
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-3624
Mailing Address - Country:US
Mailing Address - Phone:973-366-6662
Mailing Address - Fax:973-366-6682
Practice Address - Street 1:9 MOUNT PLEASANT TPKE
Practice Address - Street 2:SUIT # 203
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-3624
Practice Address - Country:US
Practice Address - Phone:973-366-6662
Practice Address - Fax:973-366-6682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1019424001223G0001X
NJ22D1022366021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty