| Smile America Pc | |
|
3201 Rt 38 Ste 102 Mt Laurel NJ 08054 | |
| (856) 722-0333 | |
| (856) 722-9882 |
| Full Name | Smile America Pc |
|---|---|
| Speciality | Dentist |
| Location | 3201 Rt 38, Mt Laurel, New Jersey |
| Authorized Official Name and Position | Tatyana A Lysenko (DOCTOR OWNER) |
| Authorized Official Contact | 8567220333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile America Pc 3201 Rt 38 Ste 102 Mt Laurel NJ 08054 Ph: (856) 722-0333 | Smile America Pc 3201 Rt 38 Ste 102 Mt Laurel NJ 08054 Ph: (856) 722-0333 |
| NPI Number | 1437121399 |
|---|---|
| Provider Enumeration Date | 02/06/2006 |
| Last Update Date | 03/14/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437121399 | NPI | - | NPPES |
| 7047801 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 19107 (New Jersey) | Primary |
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