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General NPI Number Information
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NPI Number | 1174407506
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Entity Type | Organization
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Legal Business Name | MIAMI VALLEY SMILES OF HAMILTON LLC
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 2201 NW WASHINGTON BLVD STE C
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City | HAMILTON
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State | OH
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Zip | 45013-5835
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Country | US
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Telephone | 513-889-4740
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 AERO DR STE K
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City | MASON
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State | OH
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Zip | 45040-8823
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Country | US
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Telephone | 614-578-4206
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Fax |
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Authorized Official
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Title or Position | OWNER AND DENTIST
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Name | PHILLIP LANCE
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Credential | DDS
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Telephone | 614-578-4206
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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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