Provider Demographics
NPI:1447507785
Name:SMILE DESIGN SPECIALIST, L.L.C.
Entity type:Organization
Organization Name:SMILE DESIGN SPECIALIST, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:EKSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-991-1228
Mailing Address - Street 1:312 BELLEVILLE TURNPIKE
Mailing Address - Street 2:SUITE 3-B
Mailing Address - City:NORTH ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07031-6460
Mailing Address - Country:US
Mailing Address - Phone:201-991-1228
Mailing Address - Fax:201-991-7227
Practice Address - Street 1:312 BELLEVILLE TURNPIKE
Practice Address - Street 2:SUITE 3-B
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-6460
Practice Address - Country:US
Practice Address - Phone:201-991-1228
Practice Address - Fax:201-991-7227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty