Provider Demographics
NPI:1972932770
Name:SMILES BY THE SEA, L.L.C.
Entity type:Organization
Organization Name:SMILES BY THE SEA, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:SNISCAK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-681-2225
Mailing Address - Street 1:611 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELMAR
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-5102
Mailing Address - Country:US
Mailing Address - Phone:732-681-2225
Mailing Address - Fax:732-681-2225
Practice Address - Street 1:611 MAIN ST
Practice Address - Street 2:
Practice Address - City:BELMAR
Practice Address - State:NJ
Practice Address - Zip Code:07719-5102
Practice Address - Country:US
Practice Address - Phone:732-681-2225
Practice Address - Fax:732-681-0033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental