Provider Demographics
NPI:1447760970
Name:SMILES 4 A LIFETIME PC
Entity Type:Organization
Organization Name:SMILES 4 A LIFETIME PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-374-2883
Mailing Address - Street 1:141 FRANKLIN PL STE A
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1244
Mailing Address - Country:US
Mailing Address - Phone:516-374-2883
Mailing Address - Fax:516-374-2644
Practice Address - Street 1:141 FRANKLIN PL STE A
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1244
Practice Address - Country:US
Practice Address - Phone:516-374-2883
Practice Address - Fax:516-374-2644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty