Healthcare Provider Details

I. General information

NPI: 1730506791
Provider Name (Legal Business Name): SMILES IN THE VILLAGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 03/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2169 GLEBE ST SUITE 200
CARMEL IN
46032-7294
US

IV. Provider business mailing address

2169 GLEBE ST SUITE 200
CARMEL IN
46032-7294
US

V. Phone/Fax

Practice location:
  • Phone: 317-575-6101
  • Fax:
Mailing address:
  • Phone: 317-575-6101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number12009945A
License Number StateIN

VIII. Authorized Official

Name: YUVAL ARAZI
Title or Position: OWNER
Credential: DDS
Phone: 317-575-6101