Provider Demographics
NPI:1942486840
Name:DELAWARE SMILE CENTER
Entity type:Organization
Organization Name:DELAWARE SMILE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAQIB
Authorized Official - Middle Name:
Authorized Official - Last Name:USMANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-285-7645
Mailing Address - Street 1:201 CARTER DRIVE
Mailing Address - Street 2:STE #A
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 CARTER DR
Practice Address - Street 2:STE #A
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-5843
Practice Address - Country:US
Practice Address - Phone:302-285-7645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty