Provider Demographics
NPI:1124800370
Name:SMILES BY MARIAH DENTISTRY PLLC
Entity type:Organization
Organization Name:SMILES BY MARIAH DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PEWARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:516-729-3625
Mailing Address - Street 1:188 SUMMERFIELD ST
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5479
Mailing Address - Country:US
Mailing Address - Phone:914-472-2929
Mailing Address - Fax:
Practice Address - Street 1:188 SUMMERFIELD ST
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5479
Practice Address - Country:US
Practice Address - Phone:914-472-2929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty