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General NPI Number Information
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NPI Number | 1730485871
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Entity Type | Organization
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Legal Business Name | ALL ABOUT SMILES
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Dates
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Enumeration Date | 02/08/2011
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 659 S BREIEL BLVD UNIT 27
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City | MIDDLETOWN
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State | OH
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Zip | 45044-5113
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Country | US
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Telephone | 513-423-0779
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Fax | 513-423-7731
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Provider Business Mailing Address
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Address Line | 659 S BREIEL BLVD UNIT 27
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City | MIDDLETOWN
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State | OH
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Zip | 45044-5113
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Country | US
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Telephone | 513-423-0779
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Fax | 513-423-7731
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Authorized Official
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Title or Position | CEO
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Name | DR. JAMES C PUCCIO
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Credential | DDS
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Telephone | 513-423-0779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 30019191
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License Number State | OH
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