Provider Demographics
NPI:1801673868
Name:SAILFISH SMILES, PLLC
Entity type:Organization
Organization Name:SAILFISH SMILES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:SOPHIA
Authorized Official - Last Name:GUERRINO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:914-879-9558
Mailing Address - Street 1:700 W GRANADA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-5194
Mailing Address - Country:US
Mailing Address - Phone:914-879-9558
Mailing Address - Fax:
Practice Address - Street 1:2614 SE WILLOUGHBY BLVD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4700
Practice Address - Country:US
Practice Address - Phone:914-879-9558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty