Provider Demographics
NPI:1891231023
Name:SMILE DENTAL, PC
Entity Type:Organization
Organization Name:SMILE DENTAL, PC
Other - Org Name:HAPPY SMILES DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:TROMBLY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-284-2275
Mailing Address - Street 1:320 WASHINGTON ST
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-6873
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:320 WASHINGTON ST
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-6873
Practice Address - Country:US
Practice Address - Phone:617-860-3640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMILE DENTAL, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN19319122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty