Provider Demographics
NPI:1568277697
Name:SMILE DENTAL CARE LLC
Entity type:Organization
Organization Name:SMILE DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:VEGA REYES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-425-9779
Mailing Address - Street 1:1995 CARR #2
Mailing Address - Street 2:METRO MEDICAL CENTER A-301
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-425-9779
Mailing Address - Fax:
Practice Address - Street 1:1995 CARR #2
Practice Address - Street 2:METRO MEDICAL CENTER A-301
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-425-9779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty