Provider Demographics
NPI:1346085958
Name:NEW SMILE DENTAL GROUP
Entity type:Organization
Organization Name:NEW SMILE DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AN
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-268-3036
Mailing Address - Street 1:7450 CLAIREMONT MESA BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1556
Mailing Address - Country:US
Mailing Address - Phone:858-268-3036
Mailing Address - Fax:858-703-6455
Practice Address - Street 1:7450 CLAIREMONT MESA BLVD STE 201
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1556
Practice Address - Country:US
Practice Address - Phone:858-268-3036
Practice Address - Fax:858-703-6455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental