Provider Demographics
NPI:1245709211
Name:SPLENDID SMILES FAMILY DENTISTRY
Entity type:Organization
Organization Name:SPLENDID SMILES FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:R
Authorized Official - Last Name:CORAPI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:848-222-1455
Mailing Address - Street 1:495 W VETERANS HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-3757
Mailing Address - Country:US
Mailing Address - Phone:848-222-1455
Mailing Address - Fax:848-222-1454
Practice Address - Street 1:495 W VETERANS HWY STE 1
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-3757
Practice Address - Country:US
Practice Address - Phone:848-222-1455
Practice Address - Fax:848-222-1454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty