Provider Demographics
NPI:1326706532
Name:OCEAN PEDIATRIC SMILES
Entity Type:Organization
Organization Name:OCEAN PEDIATRIC SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:SONES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-473-1123
Mailing Address - Street 1:368 LAKEHURST RD STE 305
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-7341
Mailing Address - Country:US
Mailing Address - Phone:732-473-1123
Mailing Address - Fax:732-473-1133
Practice Address - Street 1:368 LAKEHURST RD STE 305
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-7341
Practice Address - Country:US
Practice Address - Phone:732-473-1123
Practice Address - Fax:732-473-1133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-04
Last Update Date:2021-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty