Provider Demographics
NPI:1962193128
Name:SMILING MOLAR DENTAL PA
Entity type:Organization
Organization Name:SMILING MOLAR DENTAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEETU
Authorized Official - Middle Name:
Authorized Official - Last Name:BHANUSHALI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:908-633-4200
Mailing Address - Street 1:235 MEADOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-2502
Mailing Address - Country:US
Mailing Address - Phone:908-633-4200
Mailing Address - Fax:
Practice Address - Street 1:1024 PARK AVE STE 6C
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3015
Practice Address - Country:US
Practice Address - Phone:908-633-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty