Provider Demographics
NPI:1902478761
Name:PERFECT SMILE DENTAL OF ERIE, LLC
Entity Type:Organization
Organization Name:PERFECT SMILE DENTAL OF ERIE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-866-8650
Mailing Address - Street 1:6660 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-7720
Mailing Address - Country:US
Mailing Address - Phone:814-866-8650
Mailing Address - Fax:
Practice Address - Street 1:6660 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-7720
Practice Address - Country:US
Practice Address - Phone:814-866-8650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty