Healthcare Provider Details

I. General information

NPI: 1356245344
Provider Name (Legal Business Name): SMILE STRAIGHT ORTHO DORR - ROBERTS DMD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5220 DORR STREET STE B
TOLEDO OH
43615
US

IV. Provider business mailing address

5220 DORR STREET STE B
TOLEDO OH
43615
US

V. Phone/Fax

Practice location:
  • Phone: 567-389-9891
  • Fax:
Mailing address:
  • Phone: 567-389-9891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: TERESA ZWICKY
Title or Position: CRED MGR
Credential:
Phone: 480-866-8811