Provider Demographics
NPI:1700477171
Name:SMILE WITH STYLE LLC
Entity Type:Organization
Organization Name:SMILE WITH STYLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MINA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSSEF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-365-8593
Mailing Address - Street 1:821 BERGEN AVE APT B2
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-4522
Mailing Address - Country:US
Mailing Address - Phone:201-365-8593
Mailing Address - Fax:
Practice Address - Street 1:873 BERGEN AVE FL 1
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-4405
Practice Address - Country:US
Practice Address - Phone:201-365-8593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty