Simply Smile Dental PC

NPI #1295194363 in Glendale, New York

Provider Information

NPI Number: 1295194363
Entity Type: Organization
Organization Name: Simply Smile Dental PC
Primary Specialty: Dentist
Enumeration Date: Feb 18, 2016
Last Updated: Feb 18, 2016

Practice Location

Address: 6222 MYRTLE AVE
City: Glendale
State: New York
ZIP Code: 11385-6236
Phone: (718) 821-7432

Authorized Official

Name: JUAN CARLOS PORTELA, DMD
Title: PRESIDENT
Phone: (347) 924-7736

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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