Organization
SMILE LOFT FAIR LAWN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OXANA RAYSKAYA (DIRECTOR OF AR)
(347) 545-2557
Entity
Organization
Contact information
Practice address
32-16 BROADWAY STE 201, FAIR LAWN, NJ 07410-4600
(201) 794-0440
Mailing address
32-16 BROADWAY STE 201, FAIR LAWN, NJ 07410-4600
(201) 794-0440
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/07/2023
Last updated
10/10/2023
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