MEDICARE: SMILECREATOR OF NAPLES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1699273706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMILECREATOR OF NAPLES LLC

Provider Business Mailing Address
First Line	:	987 HIGH POINT DR STE 102
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34103-3877
Country	:	US
Telephone Number	:	239-564-3100
Fax Number	:

Provider Business Practice Location Address
First Line	:	987 HIGH POINT DR STE 102
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34103-3877
Country	:	US
Telephone Number	:	239-564-3100
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. NILO ARTEMIO HERNANDEZ JR.
Credential	:	DDS
Telephone Number	:	239-692-7511

Provider Enumeration Date	:	01/24/2018
Last Update Date	:	03/28/2018

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Directions to “SMILECREATOR OF NAPLES LLC ” Practice Location

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