Provider Demographics
NPI:1700911286
Name:SMILES UNLIMITED DENTAL CENTER, PC
Entity Type:Organization
Organization Name:SMILES UNLIMITED DENTAL CENTER, PC
Other - Org Name:SMILES UNLIMITED DENTAL CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:T
Authorized Official - Last Name:KESLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:908-722-5511
Mailing Address - Street 1:60 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08835-1864
Mailing Address - Country:US
Mailing Address - Phone:908-722-5511
Mailing Address - Fax:908-722-5733
Practice Address - Street 1:60 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08835-1864
Practice Address - Country:US
Practice Address - Phone:908-722-5511
Practice Address - Fax:908-722-5733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI020787001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty