Provider Demographics
NPI:1194127738
Name:ART OF SMILE
Entity type:Organization
Organization Name:ART OF SMILE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUTOVOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-342-9000
Mailing Address - Street 1:PO BOX 6104
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-6104
Mailing Address - Country:US
Mailing Address - Phone:215-342-9000
Mailing Address - Fax:215-342-9100
Practice Address - Street 1:8332 BUSTLETON AVE
Practice Address - Street 2:UNIT C
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-1909
Practice Address - Country:US
Practice Address - Phone:215-342-9000
Practice Address - Fax:215-342-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-25
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020408L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty