Organization
SMILE TELEDENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASKIREN JIT GILL (FOUNDER)
(412) 596-7203
Entity
Organization
Contact information
Practice address
9550 HEATHERBROOK PL, RANCHO CUCAMONGA, CA 91730-7910
(412) 596-7203
Mailing address
7451 AUBURN BLVD STE C, CITRUS HEIGHTS, CA 95610-2992
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y8343349
DL
CA
Enumeration date
06/13/2022
Last updated
06/13/2022
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