| Organization Name: | ATLANTIC SMILES LLC |
| NPI Number: | 1023273695 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARC JOSEPH PUKENAS (DENTIST/OWNER) |
| Mailing Address: | 3069 English Creek Ave Suite #304 Egg Harbor Township |
| State: | NJ US |
| Postal Code: | 082349708 |
| Phone Number: | 6096451900 |
| Fax Number: | |
| NPI Enumeration Date: | 07/23/2008 |
| NPI Last Update Date: | 07/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DI 02299000 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |