Beautiful Smiles Elbridge, LLC

Organization Active NPI General Practice Dentistry · Elbridge, NY

NPI 1740603000 · NPPES record last updated Jan 22, 2014

Key facts

NPI
1740603000
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
038541 (NY)
Legal business name
BEAUTIFUL SMILES ELBRIDGE, LLC
Practice address
239 E Main St
Elbridge, NY 13060-8706
Phone
(315) 277-5039
NPI assigned
Jan 22, 2014
Organization subpart
No

Authorized official

Name
Dr. David Gerard Nangle, DDS
Title
Partner/Dentist
Phone
(315) 277-5039

National Provider Directory

Locations

239 E Main St
Elbridge, NY 13060
Phone (315) 277-5039

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X 038541 NY Yes

Addresses

Primary practice location

239 E Main St
Elbridge, NY 13060-8706

Mailing address

239 E Main St
Elbridge, NY 13060-8706
Phone (315) 277-5039

Other identifiers

IdentifierTypeStateIssuer
00842439MedicaidNY

Other providers in Elbridge, NY

All providers in Elbridge, NY · General Practice Dentistry in New York

Sources for this page

Verify at the official NPI Registry.