Provider Demographics
NPI:1508460411
Name:SMILE UPPER EAST DENTAL PLLC
Entity Type:Organization
Organization Name:SMILE UPPER EAST DENTAL PLLC
Other - Org Name:SMILE UP DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-897-1833
Mailing Address - Street 1:325 EAST 79TH ST
Mailing Address - Street 2:UNIT 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075
Mailing Address - Country:US
Mailing Address - Phone:212-897-1833
Mailing Address - Fax:914-339-5570
Practice Address - Street 1:325 EAST 79TH ST
Practice Address - Street 2:UNIT 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075
Practice Address - Country:US
Practice Address - Phone:212-897-1833
Practice Address - Fax:914-339-5570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty