Provider Demographics
NPI:1386114429
Name:BRANCHBURG SMILES LLC
Entity type:Organization
Organization Name:BRANCHBURG SMILES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-541-1100
Mailing Address - Street 1:3322 RTE 22 STE 1306
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-4409
Mailing Address - Country:US
Mailing Address - Phone:908-541-1100
Mailing Address - Fax:
Practice Address - Street 1:3322 RTE 22 STE 1306
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-4409
Practice Address - Country:US
Practice Address - Phone:609-903-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-02
Last Update Date:2018-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental