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General NPI Number Information
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NPI Number | 1609206580
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Entity Type | Organization
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Legal Business Name | SMILES FOR LIFE ORTHODONTICS
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Dates
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Enumeration Date | 11/14/2013
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 7215 LEBANON RD. SUITE B
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City | CHARLOTTE
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State | NC
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Zip | 28227
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Country | US
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Telephone | 704-545-2018
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Fax | 704-545-2008
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Provider Business Mailing Address
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Address Line | 7215 LEBANON RD. SUITE B
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City | CHARLOTTE
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State | NC
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Zip | 28227
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Country | US
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Telephone | 704-545-2018
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Fax | 704-545-2008
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | WESLEY L. ROBINSON
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Credential | DMD, P.A.
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Telephone | 704-545-2018
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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 | 7891
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License Number State | NC
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