# NUSMILE DENTAL LLC

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

## Provider details

- **NPI number:** 1952865933
- **Authorized official:** VIJI SEETHRAMAN DDS (BUISNESS OWNER)
- **Authorized official phone:** (732) 666-7415

## Contact information

- **Practice address:** 10107 VERREE RD, PHILADELPHIA, PA 19116-3613
- **Practice address phone:** (267) 388-7754
- **Mailing address:** 10107 VERREE RD, PHILADELPHIA, PA 19116-3613
- **Mailing address phone:** (267) 388-7754

## Taxonomy

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

## Other

- **Enumeration date:** 01/24/2019
- **Last updated:** 01/24/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | DS039249 | STATE LICENSE | PA |