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General NPI Number Information
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NPI Number | 1366100893
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Entity Type | Organization
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Legal Business Name | SMILES4LIFE
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Dates
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Enumeration Date | 12/01/2021
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 235 W NOBLE AVE
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City | VISALIA
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State | CA
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Zip | 93277-2631
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Country | US
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Telephone | 559-636-8114
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Fax | 559-636-7063
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Provider Business Mailing Address
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Address Line | 235 W NOBLE AVE
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City | VISALIA
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State | CA
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Zip | 93277-2631
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Country | US
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Telephone | 559-636-8114
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Fax | 559-636-7063
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | MEHWISH RASHID
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Credential | DDDS
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Telephone | 559-636-8114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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