Provider Demographics
NPI:1356943955
Name:SMILE DESIGNS 101
Entity type:Organization
Organization Name:SMILE DESIGNS 101
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNFER
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPOSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-247-7417
Mailing Address - Street 1:900 EASTON AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1760
Mailing Address - Country:US
Mailing Address - Phone:732-247-7417
Mailing Address - Fax:732-828-7729
Practice Address - Street 1:900 EASTON AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1760
Practice Address - Country:US
Practice Address - Phone:732-247-7417
Practice Address - Fax:732-828-7729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty