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General NPI Number Information
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NPI Number | 1194221150
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Entity Type | Organization
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Legal Business Name | SMILES BIG AND SMALL, INC
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Dates
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Enumeration Date | 03/30/2018
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Last Update Date | 03/30/2018
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Provider Practice Location Address
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Address Line | 28 SANDERSDALE RD
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City | SOUTHBRIDGE
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State | MA
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Zip | 01550-2800
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Country | US
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Telephone | 617-571-1697
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Fax |
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Provider Business Mailing Address
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Address Line | 28 SANDERSDALE RD
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City | SOUTHBRIDGE
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State | MA
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Zip | 01550-2800
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VALERIE M OSBORN
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Credential | RDH
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Telephone | 617-571-1697
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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 |
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License Number State |
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