Organization
SMILE USA FOR RECONSTRUCTIVE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANKAR IYER DDS MDS (PRESIDENT)
(908) 527-8880
Entity
Organization
Contact information
Practice address
469 MORRIS AVE, STE. 300, ELIZABETH, NJ 07208-1967
(908) 527-8880
(908) 527-8587
Mailing address
469 MORRIS AVE STE 300, ELIZABETH, NJ 07208-1967
(908) 527-8880
(908) 527-8587
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1020481
NJ
1223P0700X
Prosthodontics
Primary
19245
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7221509
—
NJ
Enumeration date
04/15/2008
Last updated
04/15/2008
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