Provider Demographics
NPI:1467829762
Name:SMILES BY THE SEA FAMILY DENTISTRY
Entity Type:Organization
Organization Name:SMILES BY THE SEA FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HARBPINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEVCHENKO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-913-8985
Mailing Address - Street 1:2 DEARBORN AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-3318
Mailing Address - Country:US
Mailing Address - Phone:603-926-8827
Mailing Address - Fax:
Practice Address - Street 1:2 DEARBORN AVE
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-3318
Practice Address - Country:US
Practice Address - Phone:603-926-8827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-22
Last Update Date:2015-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04090261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental