Provider Demographics
NPI:1497392161
Name:SMILE CULTURE DENTAL PC
Entity Type:Organization
Organization Name:SMILE CULTURE DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARSHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGHARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-946-3655
Mailing Address - Street 1:1210 NORTHBROOK DR STE 400
Mailing Address - Street 2:
Mailing Address - City:TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-8428
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2150 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1740
Practice Address - Country:US
Practice Address - Phone:267-778-1216
Practice Address - Fax:267-288-5339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty