Provider Demographics
NPI:1730905308
Name:SMILE BRIGHT DENTAL, PLLC
Entity type:Organization
Organization Name:SMILE BRIGHT DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEMETRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALAMATENIOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-943-8568
Mailing Address - Street 1:572 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-4787
Mailing Address - Country:US
Mailing Address - Phone:845-628-8196
Mailing Address - Fax:
Practice Address - Street 1:572 ROUTE 6
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-4787
Practice Address - Country:US
Practice Address - Phone:845-628-8196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-28
Last Update Date:2024-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental