Provider Demographics
NPI:1225842875
Name:T-TOWN SMILES
Entity type:Organization
Organization Name:T-TOWN SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-270-7093
Mailing Address - Street 1:5635 RUDYARD RD
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2045
Mailing Address - Country:US
Mailing Address - Phone:419-270-7093
Mailing Address - Fax:
Practice Address - Street 1:5635 RUDYARD RD
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2045
Practice Address - Country:US
Practice Address - Phone:419-270-7093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty