# BLOOMING SMILE DENTAL ASSOCIATION LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1386466829
- **Authorized official:** ROLA OWIES DMD (OWNER)
- **Authorized official phone:** (973) 337-7444

## Contact information

- **Practice address:** 946 MAIN ST, 1ST FLOOR, HACKENSACK, NJ 07601
- **Practice address phone:** (201) 971-8777
- **Mailing address:** 946 MAIN ST, 1ST FLOOR, HACKENSACK, NJ 07601

## Taxonomy

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

## Other

- **Enumeration date:** 10/28/2024
- **Last updated:** 10/28/2024