# MIDJERSEY SMILES LLC

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

## Provider details

- **NPI number:** 1609314962
- **Authorized official:** KUMA KALARIA (PARTNER)
- **Authorized official phone:** (732) 727-0895

## Contact information

- **Practice address:** 1447 ROUTE 18, OLD BRIDGE, NJ 08857
- **Practice address phone:** (732) 727-0895
- **Mailing address:** 1447 ROUTE 18, OLD BRIDGE, NJ 08857
- **Mailing address phone:** (732) 727-0895

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 22DI02383502 | NJ | Yes |
| 122300000X | Dentist | 22DI02406100 | NJ | — |

## Other

- **Enumeration date:** 02/07/2017
- **Last updated:** 02/07/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1053577833 | HEALTH CARE PROVIDER | NJ |
| 01 | — | 1750616389 | HEALTH CARE PROVIDER | NJ |