Provider Demographics
NPI:1447527353
Name:NEW SMILE DENTISTRY, PA
Entity type:Organization
Organization Name:NEW SMILE DENTISTRY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FIRAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MAROUF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-327-0731
Mailing Address - Street 1:620 W STATE ROAD 434
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5330
Mailing Address - Country:US
Mailing Address - Phone:407-327-0731
Mailing Address - Fax:407-327-1018
Practice Address - Street 1:620 W STATE ROAD 434
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5330
Practice Address - Country:US
Practice Address - Phone:407-327-0731
Practice Address - Fax:407-327-1018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-20
Last Update Date:2011-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17064122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty