Provider Demographics
NPI:1912238767
Name:DENT-AL SMILES, LTD
Entity Type:Organization
Organization Name:DENT-AL SMILES, LTD
Other - Org Name:DENT-AL SMILES OF FOREST HILLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:PENG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:814-942-4699
Mailing Address - Street 1:125 EAST PLEASANT VALLEY BLVD.
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-5544
Mailing Address - Country:US
Mailing Address - Phone:814-942-4699
Mailing Address - Fax:814-942-4587
Practice Address - Street 1:21 YOST BLVD
Practice Address - Street 2:SUITE 215
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-5225
Practice Address - Country:US
Practice Address - Phone:412-824-8830
Practice Address - Fax:412-824-0493
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENT-AL SMILES, LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-19
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty