Provider Demographics
NPI:1851849079
Name:MODERN SMILES DENTAL CARE
Entity type:Organization
Organization Name:MODERN SMILES DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALHOTRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-317-9490
Mailing Address - Street 1:120 CAMBRIDGE ST
Mailing Address - Street 2:SUITE #11
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4135
Mailing Address - Country:US
Mailing Address - Phone:781-505-1900
Mailing Address - Fax:
Practice Address - Street 1:120 CAMBRIDGE ST
Practice Address - Street 2:SUITE #11
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4135
Practice Address - Country:US
Practice Address - Phone:781-505-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN201281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty