Provider Demographics
NPI:1780188938
Name:PAOLA MARIEL WAINBERG P.A.
Entity Type:Organization
Organization Name:PAOLA MARIEL WAINBERG P.A.
Other - Org Name:WAY TO SMILE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAOLA
Authorized Official - Middle Name:MARIEL
Authorized Official - Last Name:WAINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-720-9707
Mailing Address - Street 1:8060 W MCNAB RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-4254
Mailing Address - Country:US
Mailing Address - Phone:954-720-9707
Mailing Address - Fax:954-720-9705
Practice Address - Street 1:8060 W MC NAB RD
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068
Practice Address - Country:US
Practice Address - Phone:954-720-9707
Practice Address - Fax:954-720-9705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN22827122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty