Organization
CREATING SMILES FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH SANDOVAL (OWNER)
(973) 338-1100
Entity
Organization
Contact information
Practice address
1025 BROAD ST, STE 3, BLOOMFIELD, NJ 07003-2844
(973) 338-1100
Mailing address
1025 BROAD ST, STE 3, BLOOMFIELD, NJ 07003-2844
(973) 338-1100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
053693-1
NY
Other
Enumeration date
04/26/2016
Last updated
04/26/2016
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