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General NPI Number Information
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NPI Number | 1306434584
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Entity Type | Organization
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Legal Business Name | SPECIAL CARE SMILES, LLC
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Dates
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Enumeration Date | 01/04/2021
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 1325 HIGHWAY 315 BLVD STE 1
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City | WILKES BARRE
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State | PA
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Zip | 18702-7045
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Country | US
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Telephone | 570-235-1243
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Fax | 570-550-9100
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Provider Business Mailing Address
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Address Line | 1325 HIGHWAY 315 BLVD STE 1
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City | WILKES BARRE
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State | PA
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Zip | 18702-7045
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Country | US
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Telephone | 570-235-1243
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. LAURA B HOLENA
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Credential | DDS
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Telephone | 570-235-1243
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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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