Provider Demographics
NPI:1467922872
Name:ALL SMILES BIG AND SMALL, PA
Entity Type:Organization
Organization Name:ALL SMILES BIG AND SMALL, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:JSHUA
Authorized Official - Last Name:SANGALANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-204-9144
Mailing Address - Street 1:10920 MOSS PARK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-6086
Mailing Address - Country:US
Mailing Address - Phone:407-204-9144
Mailing Address - Fax:407-901-4522
Practice Address - Street 1:10920 MOSS PARK RD STE 100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6086
Practice Address - Country:US
Practice Address - Phone:407-204-9144
Practice Address - Fax:407-901-4522
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALL SMILES BIG AND SMALL PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty