Organization
SMILE LI DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAN LI (OWNER)
(646) 287-9300
Entity
Organization
Contact information
Practice address
525 WANAQUE AVE, STE 101, POMPTON LAKES, NJ 07442-1843
(646) 287-9300
Mailing address
8 SGT HARTZ DR, TAPPAN, NY 10983-1813
(646) 287-9300
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02496000
NJ
332BC3200X
Customized Equipment (DME)
Primary
22DI02496000
NJ
Other
Enumeration date
02/11/2017
Last updated
02/14/2017
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