| Smilist Dental Of New Jersey Llc | |
| 
					305 South Ave Garwood NJ 07027-1343  | |
| (516) 439-4756 | |
| Not Available | 
| Full Name | Smilist Dental Of New Jersey Llc | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 305 South Ave, Garwood, New Jersey | 
| Authorized Official Name and Position | Jay Khorsandi (MEMBER) | 
| Authorized Official Contact | 5164394756 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Smilist Dental Of New Jersey Llc 40 Cuttermill Rd Ste 400 Great Neck NY 11021-3213 Ph: () -  | Smilist Dental Of New Jersey Llc 305 South Ave Garwood NJ 07027-1343 Ph: (516) 439-4756  | 
| NPI Number | 1376053389 | 
|---|---|
| Provider Enumeration Date | 10/04/2017 | 
| Last Update Date | 10/04/2017 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1376053389 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 122300000X | Dentist | 22DI02564700 (New Jersey) | Secondary | 
| 1223G0001X | Dentist - General Practice | 22DI02564700 (New Jersey) | Primary | 
Clearsmile Nj Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 506 North Ave, Garwood, NJ 07027 Phone: 908-233-1760  |