Provider Demographics
NPI:1205328721
Name:MILES OF LITTLE SMILES PEDIATRIC DENTISTRY, PLLC
Entity type:Organization
Organization Name:MILES OF LITTLE SMILES PEDIATRIC DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELGRADE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:718-675-9660
Mailing Address - Street 1:220 WESTCHESTER AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2913
Mailing Address - Country:US
Mailing Address - Phone:914-949-6655
Mailing Address - Fax:
Practice Address - Street 1:220 WESTCHESTER AVE STE 104
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-2913
Practice Address - Country:US
Practice Address - Phone:914-949-6655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherIRS