# CREATING SMILES FAMILY DENTAL

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

## Provider details

- **NPI number:** 1063867117
- **Authorized official:** ELIZABETH SANDOVAL (OWNER)
- **Authorized official phone:** (973) 338-1100

## Contact information

- **Practice address:** 1025 BROAD ST, STE 3, BLOOMFIELD, NJ 07003-2844
- **Practice address phone:** (973) 338-1100
- **Mailing address:** 1025 BROAD ST, STE 3, BLOOMFIELD, NJ 07003-2844
- **Mailing address phone:** (973) 338-1100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 053693-1 | NY | Yes |

## Other

- **Enumeration date:** 04/26/2016
- **Last updated:** 04/26/2016