Provider Demographics
NPI:1700126059
Name:OCEAN SMILES, LLC
Entity Type:Organization
Organization Name:OCEAN SMILES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:STROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-421-8238
Mailing Address - Street 1:445 BRICK BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6048
Mailing Address - Country:US
Mailing Address - Phone:732-477-7740
Mailing Address - Fax:732-477-4894
Practice Address - Street 1:445 BRICK BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6048
Practice Address - Country:US
Practice Address - Phone:732-477-7740
Practice Address - Fax:732-477-4894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-24
Last Update Date:2013-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0244881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty