Provider Demographics
NPI:1568591949
Name:MILES OF SMILES FAMILY DENTISTRY LLC
Entity Type:Organization
Organization Name:MILES OF SMILES FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MABENE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-284-5050
Mailing Address - Street 1:453 US HIGHWAY 202
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-6022
Mailing Address - Country:US
Mailing Address - Phone:908-284-5050
Mailing Address - Fax:908-284-5057
Practice Address - Street 1:453 US HIGHWAY 202
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-6022
Practice Address - Country:US
Practice Address - Phone:908-284-5050
Practice Address - Fax:908-284-5057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ202531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty