Organization
KINDER SMILE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE MAE MCGRATH D.D.S - (PRESIDENT)
(973) 744-7003
Entity
Organization
Contact information
Practice address
248 LORRAINE AVE -, SUITE #12, UPPER MONTCLAIR, NJ 07043
(973) 744-7003
(973) 744-7008
Mailing address
P.O. BOX 43119, UPPER MONTCLAIR, NJ 07043
(973) 744-7003
(973) 744-7008
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
NJEI17834
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6204601
—
NJ
Enumeration date
03/19/2013
Last updated
03/19/2013
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