Provider Demographics
NPI:1417481201
Name:SMILEY DENTAL CARE
Entity Type:Organization
Organization Name:SMILEY DENTAL CARE
Other - Org Name:SMILEY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:APARNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANNA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-335-1167
Mailing Address - Street 1:950 AMERICAN LEGION HWY
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-4701
Mailing Address - Country:US
Mailing Address - Phone:857-888-8000
Mailing Address - Fax:
Practice Address - Street 1:950 AMERICAN LEGION HWY
Practice Address - Street 2:SUITE 6
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-4701
Practice Address - Country:US
Practice Address - Phone:857-888-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental