Organization
BEAUTIFUL SMILES ELBRIDGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GERARD NANGLE DDS (PARTNER/DENTIST)
(315) 277-5039
Entity
Organization
Contact information
Practice address
239 E MAIN ST, ELBRIDGE, NY 13060-8706
(315) 277-5039
Mailing address
239 E MAIN ST, ELBRIDGE, NY 13060-8706
(315) 277-5039
(315) 277-5039
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
038541
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00842439
—
NY
Enumeration date
01/22/2014
Last updated
01/22/2014
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