Provider Demographics
NPI:1922861079
Name:NYC DENTAL SMILE TEAM, PLLC
Entity Type:Organization
Organization Name:NYC DENTAL SMILE TEAM, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ENIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-318-4554
Mailing Address - Street 1:130 E 35TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3815
Mailing Address - Country:US
Mailing Address - Phone:212-685-5133
Mailing Address - Fax:
Practice Address - Street 1:130 E 35TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3815
Practice Address - Country:US
Practice Address - Phone:212-685-5133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty