Healthcare Provider Details

I. General information

NPI: 1770703654
Provider Name (Legal Business Name): THE CREATIVE SMILE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 09/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 N SALEM ST
APEX NC
27502-1427
US

IV. Provider business mailing address

103 N SALEM ST
APEX NC
27502-1427
US

V. Phone/Fax

Practice location:
  • Phone: 919-362-8797
  • Fax:
Mailing address:
  • Phone: 919-362-8797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5198
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. PRINCE ARRINGTON III
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 919-362-8797