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General NPI Number Information
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NPI Number | 1760360614
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Entity Type | Organization
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Legal Business Name | SMILES OF HOPE, INC
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 18555 LIGHTHOUSE DR
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City | DEXTER
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State | MO
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Zip | 63841-1235
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Country | US
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Telephone | 573-624-2500
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Fax | 573-624-2577
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Provider Business Mailing Address
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Address Line | PO BOX 857
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City | DEXTER
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State | MO
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Zip | 63841-0857
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Country | US
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Telephone | 573-624-2500
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Fax | 573-624-2577
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Authorized Official
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Title or Position | SR. PASTOR
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Name | TIMOTHY D. RUSSELL
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Credential |
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Telephone | 573-624-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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