Provider Demographics
NPI:1164197745
Name:MY DENTAL SMILE INC
Entity Type:Organization
Organization Name:MY DENTAL SMILE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MILAIDY
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO ESPINOSA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-723-3107
Mailing Address - Street 1:4068 FOREST HILL BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5730
Mailing Address - Country:US
Mailing Address - Phone:561-966-6404
Mailing Address - Fax:561-966-6067
Practice Address - Street 1:4068 FOREST HILL BLVD STE 6
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33406-5730
Practice Address - Country:US
Practice Address - Phone:561-966-6404
Practice Address - Fax:561-966-6067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty