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General NPI Number Information
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NPI Number | 1396568994
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Entity Type | Organization
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Legal Business Name | SMILE TIME ORTHODONTICS, LLC
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 9885 E 116TH ST STE 300
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City | FISHERS
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State | IN
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Zip | 46037-9242
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Country | US
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Telephone | 317-348-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 9885 E 116TH ST STE 300
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City | FISHERS
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State | IN
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Zip | 46037-9242
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Country | US
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Telephone | 317-348-4900
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF REVENUE CYCLE
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Name | ASHLEY WATKINS
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Credential | EFDA
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Telephone | 317-348-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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