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General NPI Number Information
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NPI Number | 1992189658
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Entity Type | Organization
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Legal Business Name | ISMILE PC
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 101 PLEASANT ST SUITE 210
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City | WORCESTER
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State | MA
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Zip | 01609-3213
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Country | US
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Telephone | 781-233-1189
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Fax |
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Provider Business Mailing Address
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Address Line | 347 CENTRAL ST
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City | SAUGUS
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State | MA
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Zip | 01906-2443
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Country | US
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Telephone | 781-233-1189
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | MR. HAN SOO LHO
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Credential |
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Telephone | 781-233-1189
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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 |
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License Number State |
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