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NPI Code Detail

MEDICARE: SMILE MORE DENTAL LLC.

MEDICARE: SMILE MORE DENTAL 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
1122300000XDentist

General Provider Information

NPI Number : 1699265165
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMILE MORE DENTAL LLC.
Provider Business Mailing Address
First Line : 523 RAVINE ST STE 2
Second Line :
City : DRAVOSBURG
State : PA
Zip : 15034-1012
Country : US
Telephone Number : 412-654-8770
Fax Number :
Provider Business Practice Location Address
First Line : 523 RAVINE ST STE 2
Second Line :
City : DRAVOSBURG
State : PA
Zip : 15034-1012
Country : US
Telephone Number : 412-654-8770
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DWIGHT MICHAEL FAIT
Credential :
Telephone Number : 412-654-8770
Provider Enumeration Date : 05/10/2018
Last Update Date : 05/11/2018

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Directions to “SMILE MORE DENTAL LLC. ” Practice Location

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