Healthcare Provider Details

I. General information

NPI: 1124607544
Provider Name (Legal Business Name): SMILE RITE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2021
Last Update Date: 04/04/2021
Certification Date: 04/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1563 E SILVER STAR RD
OCOEE FL
34761-2553
US

IV. Provider business mailing address

3309 TIMBERLINE RD W
WINTER HAVEN FL
33880-1161
US

V. Phone/Fax

Practice location:
  • Phone: 407-291-1056
  • Fax:
Mailing address:
  • Phone: 863-585-4997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JIMMY ORPHEE
Title or Position: MANAGER
Credential: DMD, MS
Phone: 863-585-4997