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General NPI Number Information
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NPI Number | 1902457765
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Entity Type | Organization
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Legal Business Name | LEX SMILES PC
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Dates
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Enumeration Date | 09/24/2019
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 27 MUZZEY ST
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City | LEXINGTON
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State | MA
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Zip | 02421-5226
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Country | US
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Telephone | 781-698-7136
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Fax | 781-860-9841
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Provider Business Mailing Address
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Address Line | 27 MUZZEY ST
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City | LEXINGTON
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State | MA
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Zip | 02421-5226
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Country | US
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Telephone | 781-862-1767
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Fax | 781-860-9841
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SATHISH GOBICHETTYPALAYAM
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Credential | DDS
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Telephone | 617-980-4734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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