# SMILE AMERICA PC

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

## Provider details

- **NPI number:** 1437121399
- **Authorized official:** MRS. TATYANA A LYSENKO DDS (DOCTOR OWNER)
- **Authorized official phone:** (856) 722-0333

## Contact information

- **Practice address:** 3201 RT 38, STE 102, MT LAUREL, NJ 08054
- **Practice address phone:** (856) 722-0333
- **Practice address fax:** (856) 722-9882
- **Mailing address:** 3201 RT 38, STE 102, MT LAUREL, NJ 08054
- **Mailing address phone:** (856) 722-0333
- **Mailing address fax:** (856) 722-9882

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 19107 | NJ | Yes |

## Other

- **Enumeration date:** 02/06/2006
- **Last updated:** 03/14/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7047801 | — | NJ |