Provider Demographics
NPI:1669648770
Name:SMIRNOVA, SVETLANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SVETLANA
Middle Name:
Last Name:SMIRNOVA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 READING RD
Mailing Address - Street 2:UNIT 112
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-2081
Mailing Address - Country:US
Mailing Address - Phone:908-782-4532
Mailing Address - Fax:908-782-6220
Practice Address - Street 1:8 READING RD
Practice Address - Street 2:UNIT 112
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-2081
Practice Address - Country:US
Practice Address - Phone:908-782-4532
Practice Address - Fax:908-782-6220
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI019747001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice