Provider Demographics
NPI:1538282223
Name:ALL FOR HAPPY SMILES DENTAL PC
Entity Type:Organization
Organization Name:ALL FOR HAPPY SMILES DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:GERMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GELB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-646-6800
Mailing Address - Street 1:3073 BRIGHTON 13TH STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235
Mailing Address - Country:US
Mailing Address - Phone:718-646-6800
Mailing Address - Fax:718-646-0202
Practice Address - Street 1:3073 BRIGHTON 13TH STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:718-646-6800
Practice Address - Fax:718-646-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0452231122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01485074Medicaid