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General NPI Number Information
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NPI Number | 1134010481
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Entity Type | Organization
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Legal Business Name | SMILESTRY PLLC
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 11/01/2025
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Provider Practice Location Address
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Address Line | 424 PAYNE RD
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City | SCARBOROUGH
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State | ME
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Zip | 04074-9514
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Country | US
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Telephone | 207-503-0030
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Fax | 207-503-0035
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Provider Business Mailing Address
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Address Line | 424 PAYNE RD STE 102
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City | SCARBOROUGH
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State | ME
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Zip | 04074-5569
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Country | US
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Telephone | 207-503-0030
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Fax | 207-503-0035
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Authorized Official
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Title or Position | FOUNDER/OWNER/GENERAL DENTIST
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Name | JULISSA MAGDALY GUERRA PERCOLLA
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Credential | DDS
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Telephone | 207-503-0030
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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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