| NPI | 1225692528 |
|---|---|
| Doing Business As | BETHPAGE SMILES FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | KRUPALI SHAH President 773-407-1004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2019-04-23 |