Provider Demographics
NPI:1831758028
Name:EZ SMILE PLLC
Entity type:Organization
Organization Name:EZ SMILE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAKUL
Authorized Official - Middle Name:H
Authorized Official - Last Name:RATHI
Authorized Official - Suffix:
Authorized Official - Credentials:BDS, MS
Authorized Official - Phone:973-932-8565
Mailing Address - Street 1:6732 HIGHWAY 6 S STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-1528
Mailing Address - Country:US
Mailing Address - Phone:281-498-2929
Mailing Address - Fax:
Practice Address - Street 1:6732 HIGHWAY 6 S STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-1528
Practice Address - Country:US
Practice Address - Phone:281-498-2929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty