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General NPI Number Information
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NPI Number | 1922587757
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Entity Type | Organization
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Legal Business Name | SMILENORTON INC.
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 08/13/2018
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Provider Practice Location Address
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Address Line | 17 NORTON RD
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City | COLUMBUS
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State | OH
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Zip | 43228-1711
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Country | US
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Telephone | 614-870-3337
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Fax | 614-870-3339
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Provider Business Mailing Address
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Address Line | 17 NORTON RD
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City | COLUMBUS
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State | OH
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Zip | 43228-1711
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Country | US
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Telephone | 614-870-3337
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Fax | 614-870-3339
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Authorized Official
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Title or Position | RECEPTIONIST
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Name | PAVLA FLANAGAN
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Credential |
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Telephone | 614-870-3337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30023039
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License Number State | OH
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