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General NPI Number Information
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NPI Number | 1942445689
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Entity Type | Organization
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Legal Business Name | SHEN'S SMILES PC
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 12/10/2008
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Provider Practice Location Address
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Address Line | 10 RITTENHOUSE PLACE
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City | DRUMS
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State | PA
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Zip | 18222
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Country | US
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Telephone | 570-956-9962
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 503
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City | DRUMS
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State | PA
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Zip | 18222-0503
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Country | US
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Telephone | 570-956-9962
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LINDA L SHEN
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Credential | DDS
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Telephone | 570-956-9962
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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 | DS035064
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License Number State | PA
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