Provider Demographics
NPI:1881124691
Name:SMILE CULTURE DENTAL PC
Entity type:Organization
Organization Name:SMILE CULTURE DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARSHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGHARA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-946-3655
Mailing Address - Street 1:537 E STREET RD
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-7772
Mailing Address - Country:US
Mailing Address - Phone:267-589-6230
Mailing Address - Fax:
Practice Address - Street 1:537 E STREET RD
Practice Address - Street 2:
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-7772
Practice Address - Country:US
Practice Address - Phone:267-589-6230
Practice Address - Fax:215-494-9389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty