Provider Demographics
NPI:1568704526
Name:THE SMILE EXPRESS PA
Entity Type:Organization
Organization Name:THE SMILE EXPRESS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEETU
Authorized Official - Middle Name:CHHABRA
Authorized Official - Last Name:SONI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:857-233-7158
Mailing Address - Street 1:713 NEW DOVER RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1910
Mailing Address - Country:US
Mailing Address - Phone:732-227-9777
Mailing Address - Fax:
Practice Address - Street 1:746 LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-2385
Practice Address - Country:US
Practice Address - Phone:732-227-9777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-17
Last Update Date:2013-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02422100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty