Provider Demographics
NPI:1780368373
Name:PEDIATRIC SMILES OF WALPOLE LLC
Entity type:Organization
Organization Name:PEDIATRIC SMILES OF WALPOLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PARNEET
Authorized Official - Middle Name:
Authorized Official - Last Name:HEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-890-2480
Mailing Address - Street 1:39 LESTER GRAY DR
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-2169
Mailing Address - Country:US
Mailing Address - Phone:206-890-2480
Mailing Address - Fax:
Practice Address - Street 1:600 MAIN ST APT 3
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-3791
Practice Address - Country:US
Practice Address - Phone:206-890-2480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty