MEDICARE: ONE SMILE, P.L.L.C.

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	1223G0001X	General Practice Dentistry	DN18859	FL

General Provider Information

NPI Number	:	1760781892
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONE SMILE, P.L.L.C.

Provider Business Mailing Address
First Line	:	1225 N MILITARY TRL
Second Line	:	SUITE 6
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6059
Country	:	US
Telephone Number	:	561-721-9992
Fax Number	:	561-686-8948

Provider Business Practice Location Address
First Line	:	1225 N MILITARY TRL
Second Line	:	SUITE 6
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6059
Country	:	US
Telephone Number	:	561-721-9992
Fax Number	:	561-686-8948

Authorized Official
Title or Position	:	MEMBER
Name	:	MIHRAN ASINMAZ
Credential	:
Telephone Number	:	561-721-9992

Provider Enumeration Date	:	03/15/2011
Last Update Date	:	03/15/2011

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