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Organization
SMILE SPACE DENTISTRY PLLC
Active
Organization
SMILE SPACE DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COREY LAVELLE BLACK DMD (CHIEF EXECUTIVE OFFICER)
(717) 395-3144
Entity
Organization
Contact information
Practice address
557 ATLANTIC AVE UNIT 2, BROOKLYN, NY 11217-4946
(717) 395-3144
Mailing address
557 ATLANTIC AVE UNIT 2, BROOKLYN, NY 11217-4946
(717) 395-3144
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/02/2026
Last updated
09/02/2026
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