Provider Demographics
NPI:1215767561
Name:D&G SMILE II
Entity type:Organization
Organization Name:D&G SMILE II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EHAB
Authorized Official - Middle Name:G
Authorized Official - Last Name:AZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-407-6958
Mailing Address - Street 1:646 STATE ROUTE 18 STE 114B
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3722
Mailing Address - Country:US
Mailing Address - Phone:732-238-1760
Mailing Address - Fax:732-390-6169
Practice Address - Street 1:646 STATE ROUTE 18 STE 114B
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3722
Practice Address - Country:US
Practice Address - Phone:732-238-1760
Practice Address - Fax:732-390-6169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental