Provider Demographics
NPI:1811398464
Name:SMILE PLUS DENTISTRY LLC
Entity Type:Organization
Organization Name:SMILE PLUS DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENUKA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-307-8023
Mailing Address - Street 1:880 POPLAR CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-2205
Mailing Address - Country:US
Mailing Address - Phone:717-307-8023
Mailing Address - Fax:717-238-5336
Practice Address - Street 1:880 POPLAR CHURCH RD
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2205
Practice Address - Country:US
Practice Address - Phone:717-307-8023
Practice Address - Fax:717-238-5336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS039837122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty