Provider Demographics
NPI:1427338656
Name:SIMPLE SMILES LLC
Entity type:Organization
Organization Name:SIMPLE SMILES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-977-8181
Mailing Address - Street 1:630 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514-1334
Mailing Address - Country:US
Mailing Address - Phone:973-977-8181
Mailing Address - Fax:973-977-8500
Practice Address - Street 1:630 11TH AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1334
Practice Address - Country:US
Practice Address - Phone:973-977-8181
Practice Address - Fax:973-977-8500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ19084261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental