Provider Demographics
NPI:1730951633
Name:SUPERSMILES DENTAL PLLC
Entity type:Organization
Organization Name:SUPERSMILES DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PARASKEVAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KOURTSOUNIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-451-7700
Mailing Address - Street 1:2318 31ST ST STE 320
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-2765
Mailing Address - Country:US
Mailing Address - Phone:718-635-3222
Mailing Address - Fax:
Practice Address - Street 1:2318 31ST ST STE 320
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-2765
Practice Address - Country:US
Practice Address - Phone:718-635-3222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty