MEDICARE: ARNOLD SMILES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	2003013103	MO
2	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1154675262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARNOLD SMILES, LLC

Provider Business Mailing Address
First Line	:	124 RICHARDSON XING
Second Line	:
City	:	ARNOLD
State	:	MO
Zip	:	63010-6023
Country	:	US
Telephone Number	:	636-464-6444
Fax Number	:

Provider Business Practice Location Address
First Line	:	124 RICHARDSON XING
Second Line	:
City	:	ARNOLD
State	:	MO
Zip	:	63010-6023
Country	:	US
Telephone Number	:	636-464-6444
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ERIN MARISCAL
Credential	:	DDS
Telephone Number	:	636-464-6444

Provider Enumeration Date	:	10/29/2012
Last Update Date	:	07/13/2021

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Directions to “ARNOLD SMILES, LLC ” Practice Location

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