Provider Demographics
NPI:1376123182
Name:SMILES 4 DURHAM INC
Entity type:Organization
Organization Name:SMILES 4 DURHAM INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:SERAG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-569-5533
Mailing Address - Street 1:370 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-1192
Mailing Address - Country:US
Mailing Address - Phone:919-569-5533
Mailing Address - Fax:
Practice Address - Street 1:370 JACKSON ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701
Practice Address - Country:US
Practice Address - Phone:919-569-5533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-14
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental