Provider Demographics
NPI:1578598744
Name:SMILE DENTAL CARE LLC
Entity Type:Organization
Organization Name:SMILE DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHANDRIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHUT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-515-5955
Mailing Address - Street 1:19785 CRYSTAL ROCK DR STE 302
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-4732
Mailing Address - Country:US
Mailing Address - Phone:301-515-5955
Mailing Address - Fax:
Practice Address - Street 1:19785 CRYSTAL ROCK DR STE 302
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-4732
Practice Address - Country:US
Practice Address - Phone:301-515-5955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD127781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty