Provider Demographics
NPI:1518636935
Name:S&W HEALTHY SMILES CORP.
Entity Type:Organization
Organization Name:S&W HEALTHY SMILES CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-400-1387
Mailing Address - Street 1:PO BOX 518 , JUNCOS ,PR 00777
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777
Mailing Address - Country:US
Mailing Address - Phone:787-235-3836
Mailing Address - Fax:
Practice Address - Street 1:CALLE MUOZ RIVERA NO16
Practice Address - Street 2:
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777
Practice Address - Country:US
Practice Address - Phone:787-991-5158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty