Provider Demographics
NPI:1992249643
Name:HAPPY SMILES DENTAL CARE
Entity type:Organization
Organization Name:HAPPY SMILES DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIS DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURICIO
Authorized Official - Middle Name:S
Authorized Official - Last Name:MONTENEGRO
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:786-542-9700
Mailing Address - Street 1:922 EAST 25 STREET
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013
Mailing Address - Country:US
Mailing Address - Phone:786-542-9700
Mailing Address - Fax:
Practice Address - Street 1:922 EAST 25 TREET
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013
Practice Address - Country:US
Practice Address - Phone:786-542-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty