Provider Demographics
NPI:1225466774
Name:DENTEX SMILE STUDIO PA
Entity Type:Organization
Organization Name:DENTEX SMILE STUDIO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EWA
Authorized Official - Middle Name:
Authorized Official - Last Name:AWAD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-500-2555
Mailing Address - Street 1:2 FRANKLIN PL
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5305
Mailing Address - Country:US
Mailing Address - Phone:973-500-2555
Mailing Address - Fax:973-500-6007
Practice Address - Street 1:2 FRANKLIN PL
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5305
Practice Address - Country:US
Practice Address - Phone:973-500-2555
Practice Address - Fax:973-500-6007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-19
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02379100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty