Provider Demographics
NPI:1306434584
Name:SPECIAL CARE SMILES, LLC
Entity type:Organization
Organization Name:SPECIAL CARE SMILES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOLENA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:570-235-1243
Mailing Address - Street 1:1325 HIGHWAY 315 BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-7045
Mailing Address - Country:US
Mailing Address - Phone:570-235-1243
Mailing Address - Fax:
Practice Address - Street 1:1325 HIGHWAY 315 BLVD STE 1
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-7045
Practice Address - Country:US
Practice Address - Phone:570-235-1243
Practice Address - Fax:570-550-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental