Provider Demographics
NPI:1679394092
Name:LEVITTOWN SMILES LLC
Entity type:Organization
Organization Name:LEVITTOWN SMILES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMEET
Authorized Official - Middle Name:
Authorized Official - Last Name:PATHEJA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-756-7223
Mailing Address - Street 1:20 AVE AT PORT IMPERIAL APT 302
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-8419
Mailing Address - Country:US
Mailing Address - Phone:215-756-7223
Mailing Address - Fax:
Practice Address - Street 1:4409 NEW FALLS RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19056-3005
Practice Address - Country:US
Practice Address - Phone:215-756-7223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty