Provider Demographics
NPI:1467931790
Name:SEA OF SMILES 3PLLC
Entity Type:Organization
Organization Name:SEA OF SMILES 3PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:267-392-5878
Mailing Address - Street 1:301 OXFORD VALLEY ROAD
Mailing Address - Street 2:SUITE 1801
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067
Mailing Address - Country:US
Mailing Address - Phone:267-392-5878
Mailing Address - Fax:412-317-1568
Practice Address - Street 1:1501 MAIN ST STE 240
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-3400
Practice Address - Country:US
Practice Address - Phone:215-433-1835
Practice Address - Fax:412-317-1568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-08
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0384621223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty