Provider Demographics
NPI:1780494682
Name:SMILE SPECIALIST FOR KIDS LLC
Entity type:Organization
Organization Name:SMILE SPECIALIST FOR KIDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DMD
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIELA
Authorized Official - Middle Name:E
Authorized Official - Last Name:RAMOS RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-406-2301
Mailing Address - Street 1:1010 CALLE ORCHID APT 502
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5978
Mailing Address - Country:US
Mailing Address - Phone:787-406-2301
Mailing Address - Fax:
Practice Address - Street 1:525 AVE FD ROOSEVELT OFC 812
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-8058
Practice Address - Country:US
Practice Address - Phone:787-751-5317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty