Provider Demographics
NPI:1295987642
Name:NU SMILE FAMILY DENTISTRY
Entity type:Organization
Organization Name:NU SMILE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMAKRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEELAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:717-464-1147
Mailing Address - Street 1:2162 WILLOW STREET PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-4838
Mailing Address - Country:US
Mailing Address - Phone:717-464-1147
Mailing Address - Fax:717-464-1198
Practice Address - Street 1:2600 WILLOWSTREET PIKE
Practice Address - Street 2:STE# 310
Practice Address - City:WILLO W STREET
Practice Address - State:PA
Practice Address - Zip Code:17584
Practice Address - Country:US
Practice Address - Phone:717-464-1147
Practice Address - Fax:717-464-1198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0353461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty