Provider Demographics
NPI:1598309106
Name:SEA OF SMILES 4 LLC
Entity Type:Organization
Organization Name:SEA OF SMILES 4 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-208-1768
Mailing Address - Street 1:301 OXFORD VALLEY RD STE 1801
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-7725
Mailing Address - Country:US
Mailing Address - Phone:267-392-5878
Mailing Address - Fax:412-317-1568
Practice Address - Street 1:361 HIGHLAND AVE STE 203
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2632
Practice Address - Country:US
Practice Address - Phone:267-392-5878
Practice Address - Fax:412-317-1568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty