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General NPI Number Information
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NPI Number | 1124309968
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Entity Type | Organization
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Legal Business Name | PROTECTING ALL SMILES, LLC
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Dates
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Enumeration Date | 09/07/2011
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Last Update Date | 09/07/2011
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Provider Practice Location Address
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Address Line | 153 PLYMOUTH BLVD
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City | WESTPORT
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State | MA
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Zip | 02790-4623
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Country | US
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Telephone | 774-930-2052
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Fax |
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Provider Business Mailing Address
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Address Line | 153 PLYMOUTH BLVD
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City | WESTPORT
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State | MA
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Zip | 02790-4623
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Country | US
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Telephone | 774-930-2052
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. ELIZABETH C CHOUINARD
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Credential | RDH
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Telephone | 774-930-2052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH12734
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH12750
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License Number State | MA
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