Provider Demographics
NPI:1669253357
Name:SMILE LOFT DENTISTRY OF ORANGETOWN, PLLC
Entity type:Organization
Organization Name:SMILE LOFT DENTISTRY OF ORANGETOWN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MALEK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:012-664-1808
Mailing Address - Street 1:450 WESTERN HWY STE B
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-2188
Mailing Address - Country:US
Mailing Address - Phone:845-359-5588
Mailing Address - Fax:
Practice Address - Street 1:450 WESTERN HWY STE B
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962-2188
Practice Address - Country:US
Practice Address - Phone:845-359-5588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental