Provider Demographics
NPI:1952141723
Name:READY SMILE DENTAL PC
Entity type:Organization
Organization Name:READY SMILE DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:POUSTOVOIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-709-4611
Mailing Address - Street 1:1502 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7283
Mailing Address - Country:US
Mailing Address - Phone:718-709-4611
Mailing Address - Fax:
Practice Address - Street 1:1502 E 14TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7283
Practice Address - Country:US
Practice Address - Phone:718-709-4611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty