Organization
ELIZABETH SMILINE DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. USHA POLAVARAPU D.D.S. (DENTIST)
(908) 351-4860
Entity
Organization
Contact information
Practice address
1206 E GRAND ST, ELIZABETH, NJ 07201-2309
(908) 351-4860
(908) 351-4865
Mailing address
1206 E GRAND ST, ELIZABETH, NJ 07201-2309
(908) 351-4860
(908) 351-4865
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI01912604
NJ
Other
Enumeration date
03/23/2011
Last updated
03/23/2011
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