Provider Demographics
NPI:1275316267
Name:SMILE WELLNESS LLC
Entity Type:Organization
Organization Name:SMILE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:POOJA
Authorized Official - Middle Name:
Authorized Official - Last Name:TANNA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:215-543-4061
Mailing Address - Street 1:1080 STELTON RD STE 201
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-5200
Mailing Address - Country:US
Mailing Address - Phone:732-572-8888
Mailing Address - Fax:
Practice Address - Street 1:1080 STELTON RD STE 201
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-5200
Practice Address - Country:US
Practice Address - Phone:732-572-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty