Provider Demographics
NPI:1730934142
Name:SMILE N' STYLE DENTAL LLC
Entity type:Organization
Organization Name:SMILE N' STYLE DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GAGANDEEP
Authorized Official - Middle Name:K
Authorized Official - Last Name:BATH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD, BDS
Authorized Official - Phone:317-987-5603
Mailing Address - Street 1:5729 E SOUTHPORT RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-9786
Mailing Address - Country:US
Mailing Address - Phone:317-987-5603
Mailing Address - Fax:
Practice Address - Street 1:11591 WESTFIELD BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3738
Practice Address - Country:US
Practice Address - Phone:317-836-5211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental