Provider Demographics
NPI:1952034589
Name:SMILE CULTURE ORTHODONTIA FOR SMILE CULTURE DENTAL PLLC
Entity Type:Organization
Organization Name:SMILE CULTURE ORTHODONTIA FOR SMILE CULTURE DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARSHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGHARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-946-3655
Mailing Address - Street 1:520 S OXFORD VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-2615
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:520 S OXFORD VALLEY RD
Practice Address - Street 2:
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030-2615
Practice Address - Country:US
Practice Address - Phone:215-946-3655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-01
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty