Provider Demographics
NPI:1013059104
Name:SMILE PLUS FAMILY DENTISTRY,INC
Entity Type:Organization
Organization Name:SMILE PLUS FAMILY DENTISTRY,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PRITI
Authorized Official - Middle Name:G
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-390-7645
Mailing Address - Street 1:385 CRANBURY RD
Mailing Address - Street 2:SUITE #3
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3000
Mailing Address - Country:US
Mailing Address - Phone:732-390-7645
Mailing Address - Fax:732-390-7345
Practice Address - Street 1:385 CRANBURY RD
Practice Address - Street 2:SUITE #3
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3000
Practice Address - Country:US
Practice Address - Phone:732-390-7645
Practice Address - Fax:732-390-7345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI021768001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty