Provider Demographics
NPI:1437531290
Name:SOMA SMILES INC.
Entity Type:Organization
Organization Name:SOMA SMILES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RASMI
Authorized Official - Middle Name:
Authorized Official - Last Name:AKEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-425-5090
Mailing Address - Street 1:3580 LAKE WORTH ROAD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461
Mailing Address - Country:US
Mailing Address - Phone:561-425-5090
Mailing Address - Fax:561-275-7177
Practice Address - Street 1:3580 LAKE WORTH ROAD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461
Practice Address - Country:US
Practice Address - Phone:561-425-5090
Practice Address - Fax:561-275-7177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-29
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15799122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty