Provider Demographics
NPI:1285465609
Name:SMILE DOC PLLC
Entity type:Organization
Organization Name:SMILE DOC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAGA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-785-7037
Mailing Address - Street 1:50 FARMER RD
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-2123
Mailing Address - Country:US
Mailing Address - Phone:603-244-3570
Mailing Address - Fax:
Practice Address - Street 1:68 ROUTE 27 UNIT 2
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:NH
Practice Address - Zip Code:03077-1256
Practice Address - Country:US
Practice Address - Phone:603-244-3570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1487272530OtherNPI