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General NPI Number Information
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NPI Number | 1942142567
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Entity Type | Organization
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Legal Business Name | EVELINA SMILES LLC
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Dates
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Enumeration Date | 04/06/2026
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Last Update Date | 04/06/2026
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Provider Practice Location Address
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Address Line | 304 MILACRON DR.
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City | FOUNTAIN INN
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State | SC
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Zip | 29644
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Country | US
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Telephone | 864-387-9748
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Fax |
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Provider Business Mailing Address
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Address Line | 5052 OLD BUNCOMBE RD STE A
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City | GREENVILLE
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State | SC
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Zip | 29617-8260
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | RICHARD CONSTANTINE
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Credential | DDS
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Telephone | 864-387-9748
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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 |
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License Number State |
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