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General NPI Number Information
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NPI Number | 1407246341
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Entity Type | Organization
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Legal Business Name | SMILE ARTS LLC
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Dates
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Enumeration Date | 01/30/2015
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Last Update Date | 01/30/2015
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Provider Practice Location Address
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Address Line | 400 ROCKBOURNE BLVD, SUITE 400
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City | CLIFTON HEIGHTS
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State | PA
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Zip | 19018-1739
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Country | US
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Telephone | 484-461-7142
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Fax | 484-461-7007
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Provider Business Mailing Address
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Address Line | 400 ROCKBOURNE BLVD, SUITE 400
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City | CLIFTON HEIGHTS
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State | PA
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Zip | 19018-1739
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Country | US
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Telephone | 484-461-7142
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Fax | 484-461-7007
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Authorized Official
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Title or Position | MEMBER
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Name | DR. AMEN DHYLLON
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Credential |
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Telephone | 213-631-6611
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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 | DS038245
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License Number State | PA
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