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Organization
SMILE MAKERS, PC
Active
Organization
SMILE MAKERS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW GHADAMI DDS (DENTIST)
(516) 633-2109
Entity
Organization
Contact information
Practice address
1192 W PENN AVE, SUITE 3, WOMELSDORF, PA 19567-9702
(610) 589-6084
(610) 589-6284
Mailing address
1192 W. PENN AVE, SUITE 3, WOMELSDORF, PA 19567
(610) 589-6084
(610) 589-6284
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS038126
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
241411041
TAX ID
PA
Enumeration date
11/29/2010
Last updated
11/29/2010
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