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General NPI Number Information
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NPI Number | 1861836157
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Entity Type | Organization
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Legal Business Name | SMILES TO YOU, PLLC
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Dates
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Enumeration Date | 04/17/2013
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 591 BLOUNT POINT RD
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-2066
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Country | US
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Telephone | 757-927-2238
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Fax | 757-223-4809
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Provider Business Mailing Address
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Address Line | 591 BLOUNT POINT RD
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-2066
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Country | US
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Telephone | 757-927-2238
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Fax | 757-223-4809
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. KATHERINE FITCHETT REYNOLDS
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Credential | RDH
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Telephone | 757-927-2238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 0443000009
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License Number State | VA
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