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General NPI Number Information
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NPI Number | 1487000667
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Entity Type | Organization
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Legal Business Name | SMILE STUDIO PC
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Dates
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Enumeration Date | 05/06/2016
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Last Update Date | 07/14/2020
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Provider Practice Location Address
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Address Line | 55 M ST SE STE 103
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City | WASHINGTON
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State | DC
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Zip | 20003-3522
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Country | US
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Telephone | 301-455-0141
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Fax |
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Provider Business Mailing Address
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Address Line | 55 M ST SE STE 103
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City | WASHINGTON
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State | DC
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Zip | 20003-3522
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Country | US
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Telephone | 202-670-4882
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Fax | 202-600-2837
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHAD JONES
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Credential | DDS
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Telephone | 202-670-4882
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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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