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General NPI Number Information
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NPI Number | 1306665872
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Entity Type | Organization
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Legal Business Name | SMILE WORTHINGTON INC
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 7174 N HIGH ST
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City | WORTHINGTON
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State | OH
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Zip | 43085-2380
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Country | US
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Telephone | 614-450-0844
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Fax |
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Provider Business Mailing Address
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Address Line | 7174 N HIGH ST
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City | WORTHINGTON
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State | OH
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Zip | 43085-2380
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Country | US
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Telephone | 614-450-0844
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMAR REDDY
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Credential |
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Telephone | 614-843-1952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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