Organization
SMILE SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANVARALI MOHAMMADH DMD (PARTNER)
(717) 884-8807
Entity
Organization
Contact information
Practice address
355 W MAIN ST, LEOLA, PA 17540-2107
(717) 884-8807
Mailing address
1000 BAYBREEZE LN, BERLIN, MD 21811-9404
(410) 382-5760
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679986194
NPI
PA
01
—
1750693024
NPI
PA
Enumeration date
07/03/2024
Last updated
07/03/2024
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