Provider Demographics
NPI:1992135883
Name:ELEGANT SMILES OF SEA GIRT LLC
Entity type:Organization
Organization Name:ELEGANT SMILES OF SEA GIRT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:STEINER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-974-9494
Mailing Address - Street 1:2130 HIGHWAY 35
Mailing Address - Street 2:SUITE 211
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-1010
Mailing Address - Country:US
Mailing Address - Phone:732-974-9494
Mailing Address - Fax:732-974-8601
Practice Address - Street 1:2130 HIGHWAY 35
Practice Address - Street 2:SUITE 211
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-1010
Practice Address - Country:US
Practice Address - Phone:732-974-9494
Practice Address - Fax:732-974-8601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty