Provider Demographics
NPI:1922788330
Name:DELTA DENTAL SMILE
Entity Type:Organization
Organization Name:DELTA DENTAL SMILE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ATUL
Authorized Official - Middle Name:CHAUHAN
Authorized Official - Last Name:SOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-999-3399
Mailing Address - Street 1:962 LUTHER DR
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-5262
Mailing Address - Country:US
Mailing Address - Phone:971-999-3399
Mailing Address - Fax:
Practice Address - Street 1:962 LUTHER DR
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-5262
Practice Address - Country:US
Practice Address - Phone:971-999-3399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental