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NPI Code Detail

MEDICARE: LITTLE SMILES LLC

MEDICARE: LITTLE SMILES 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
1122300000XDentist30.023314OH

General Provider Information

NPI Number : 1821427170
Entity Type Code : Organization
Provider Name (Legal Business Name) : LITTLE SMILES LLC
Provider Business Mailing Address
First Line : 1390 CLEVELAND AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43211-2767
Country : US
Telephone Number : 614-805-5821
Fax Number :
Provider Business Practice Location Address
First Line : 1390 CLEVELAND AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43211-2767
Country : US
Telephone Number : 614-805-5821
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MOHAMED WARSAME
Credential : DMD
Telephone Number : 614-805-5821
Provider Enumeration Date : 11/07/2013
Last Update Date : 11/07/2013

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Directions to “LITTLE SMILES LLC ” Practice Location

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