Provider Demographics
NPI:1871359489
Name:M&M SMILES LLC
Entity type:Organization
Organization Name:M&M SMILES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:MAKOS
Authorized Official - Last Name:FRASER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:609-324-9500
Mailing Address - Street 1:23203 COLUMBUS RD STE Q
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NJ
Mailing Address - Zip Code:08022-1985
Mailing Address - Country:US
Mailing Address - Phone:609-324-9500
Mailing Address - Fax:609-324-9002
Practice Address - Street 1:23203 COLUMBUS RD STE Q
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NJ
Practice Address - Zip Code:08022-1985
Practice Address - Country:US
Practice Address - Phone:609-324-9500
Practice Address - Fax:609-324-9002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty