Provider Demographics
NPI:1821361486
Name:SMARINSKY & O'GRADY D.D.S., P.A.
Entity Type:Organization
Organization Name:SMARINSKY & O'GRADY D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SMARINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-966-3531
Mailing Address - Street 1:6772 FOREST HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33413-3322
Mailing Address - Country:US
Mailing Address - Phone:561-966-3531
Mailing Address - Fax:561-966-6388
Practice Address - Street 1:6772 FOREST HILL BLVD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33413-3322
Practice Address - Country:US
Practice Address - Phone:561-966-3531
Practice Address - Fax:561-966-6388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-13
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7604261QD0000X
FL17134261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental