# SMILE DENTAL OFFICE, P.C.

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

## Provider details

- **NPI number:** 1093910143
- **Authorized official:** LESLIE TORRES (INSURANCE COORDINATOR)
- **Authorized official phone:** (973) 372-5640

## Contact information

- **Practice address:** 1152 CLINTON AVENUE, IRVINGTON, NJ 07111
- **Practice address phone:** (973) 372-5640
- **Practice address fax:** (973) 371-7697
- **Mailing address:** 1152 CLINTON AVENUE, IRVINGTON, NJ 07111
- **Mailing address phone:** (973) 372-5640
- **Mailing address fax:** (973) 371-7697

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 19126 | NJ | Yes |

## Other

- **Enumeration date:** 06/19/2007
- **Last updated:** 02/15/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9025600 | — | NJ |