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General NPI Number Information
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NPI Number | 1861836900
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Entity Type | Organization
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Legal Business Name | TODAY'S SMILE, LLC
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Dates
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Enumeration Date | 04/19/2013
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Last Update Date | 04/19/2013
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Provider Practice Location Address
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Address Line | 10025 GOVERNOR WARFIELD PKWY STE 218
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City | COLUMBIA
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State | MD
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Zip | 21044-3336
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Country | US
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Telephone | 410-997-8383
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Fax | 410-997-8434
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Provider Business Mailing Address
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Address Line | 10025 GOVERNOR WARFIELD PKWY STE 218
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City | COLUMBIA
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State | MD
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Zip | 21044-3336
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Country | US
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Telephone | 410-997-8383
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Fax | 410-997-8434
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STANLEY J. PARK
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Credential |
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Telephone | 410-997-8383
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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 | 13144
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License Number State | MD
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