Provider Demographics
NPI:1982260964
Name:I SMILE LAWRENCEVILLE PC
Entity Type:Organization
Organization Name:I SMILE LAWRENCEVILLE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DMITRY
Authorized Official - Middle Name:
Authorized Official - Last Name:KARAGODSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:215-834-0678
Mailing Address - Street 1:111 LAWRENCEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-4307
Mailing Address - Country:US
Mailing Address - Phone:609-599-4800
Mailing Address - Fax:215-969-2015
Practice Address - Street 1:111 LAWRENCEVILLE RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-4307
Practice Address - Country:US
Practice Address - Phone:609-599-4800
Practice Address - Fax:215-969-2015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty