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SMILE DENTAL PC NPI 1053618140


NPI Information

NPI: 1053618140
Provider Name: SMILE DENTAL, PC

Doing Business As: BROADWAY DENTAL

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
144 BROADWAY # 2
REVERE, MA
ZIP 02151
Phone: (781) 284-2275
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SMILE DENTAL, PC is a general practice dentist in Revere, MA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. SMILE DENTAL, PC NPI is 1053618140. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Broadway Dental.

The provider's business location address is:

144 BROADWAY # 2
REVERE, MA
ZIP 02151-349
Phone: (781) 284-2275
Fax: (781) 426-7614

The provider's authorized official is Bella Ostrovsky .
The authorized official title is Manager and has the following contact phone number (781) 284-2275.

The enumeration date for this NPI number is 2/25/2011 and was last updated on 10/12/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeDN19044MASSACHUSETTSYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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