Organization
GREAT SMILES ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PANKAJ PURI DDS (CO-OWNER)
(908) 347-5724
Entity
Organization
Contact information
Practice address
559 SPEEDWELL AVE, MORRIS PLAINS, NJ 07950-2122
(908) 347-5724
Mailing address
8 DEBRA CT, SCOTCH PLAINS, NJ 07076-2827
(908) 347-5724
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DI20733
NJ
Other
Enumeration date
09/05/2017
Last updated
09/05/2017
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