| Organization Name: | SMILES BY THE SEA, L.L.C. |
| NPI Number: | 1972932770 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS J. SNISCAK (OWNER) |
| Mailing Address: | 611 Main St Belmar |
| State: | NJ US |
| Postal Code: | 077195102 |
| Phone Number: | 7326812225 |
| Fax Number: | 7326810033 |
| NPI Enumeration Date: | 11/02/2013 |
| NPI Last Update Date: | 11/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |