Provider Demographics
NPI:1023353083
Name:A NEW SMILE DENTAL CENTER
Entity type:Organization
Organization Name:A NEW SMILE DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABERGEL-NAHON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-383-9944
Mailing Address - Street 1:14050 SW 84TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4440
Mailing Address - Country:US
Mailing Address - Phone:305-383-9944
Mailing Address - Fax:
Practice Address - Street 1:14050 SW 84TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4440
Practice Address - Country:US
Practice Address - Phone:305-383-9944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL192761223G0001X
FL149601223G0001X
FL183671223G0001X
FL130981223G0001X
FL187551223P0106X
FL112061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Single Specialty