# PRISTINE SMILES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063176576
- **Authorized official:** DEEPAK PANKAJ MEHTA (OWNER)
- **Authorized official phone:** (856) 361-8069

## Contact information

- **Practice address:** 2301 E EVESHAM RD STE 105, VOORHEES, NJ 08043-4502
- **Practice address phone:** (856) 361-8069
- **Mailing address:** 3305 ABITARE BLVD, VOORHEES, NJ 08043-2687
- **Mailing address phone:** (856) 361-8069

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/30/2021
- **Last updated:** 10/30/2021