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Organization
SURFSIDE SMILE COMPANY LLC
Active
Organization
SURFSIDE SMILE COMPANY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIANNE MACARAEG KRACKE DMD (OWNER)
(757) 214-1091
Entity
Organization
Contact information
Practice address
1692 HIGHWAY 35, MIDDLETOWN, NJ 07748
(757) 214-1091
Mailing address
2404 CHERRY ST, MANASQUAN, NJ 08736-1523
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/31/2022
Last updated
01/28/2023
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