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General NPI Number Information
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NPI Number | 1124607544
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Entity Type | Organization
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Legal Business Name | SMILE RITE
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Dates
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Enumeration Date | 04/04/2021
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Last Update Date | 04/04/2021
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Provider Practice Location Address
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Address Line | 1563 E SILVER STAR RD
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City | OCOEE
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State | FL
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Zip | 34761-2553
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Country | US
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Telephone | 407-291-1056
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Fax |
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Provider Business Mailing Address
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Address Line | 3309 TIMBERLINE RD W
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City | WINTER HAVEN
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State | FL
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Zip | 33880-1161
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Country | US
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Telephone | 863-585-4997
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. JIMMY ORPHEE
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Credential | DMD, MS
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Telephone | 863-585-4997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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