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General NPI Number Information
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NPI Number | 1033354790
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Entity Type | Organization
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Legal Business Name | SMILES 18 INC
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 12/10/2008
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Provider Practice Location Address
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Address Line | 60 S JAMES RD
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City | COLUMBUS
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State | OH
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Zip | 43213-1621
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Country | US
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Telephone | 614-231-8500
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Fax | 614-253-0005
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Provider Business Mailing Address
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Address Line | 60 S JAMES RD
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City | COLUMBUS
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State | OH
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Zip | 43213-1621
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Country | US
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Telephone | 614-231-8500
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Fax | 614-253-0005
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Authorized Official
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Title or Position | CEO
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Name | MS. CYNTHIA LEVY
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Credential |
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Telephone | 614-354-8873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30016150
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License Number State | OH
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