Provider Demographics
NPI:1285170035
Name:PRETTY SMILES DENTURES & MORE LLC.
Entity type:Organization
Organization Name:PRETTY SMILES DENTURES & MORE LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:TANASE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-636-5120
Mailing Address - Street 1:19123 W MCNICHOLS RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-4008
Mailing Address - Country:US
Mailing Address - Phone:248-636-5120
Mailing Address - Fax:
Practice Address - Street 1:19123 W MCNICHOLS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-4008
Practice Address - Country:US
Practice Address - Phone:248-636-5120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty