Provider Demographics
NPI:1346953072
Name:MOXY DENTAL AND AIRWAY
Entity type:Organization
Organization Name:MOXY DENTAL AND AIRWAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:SMEDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:616-772-7010
Mailing Address - Street 1:133 1/2 E MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-1735
Mailing Address - Country:US
Mailing Address - Phone:616-772-7010
Mailing Address - Fax:616-772-7225
Practice Address - Street 1:133 1/2 E MAIN AVE
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-1735
Practice Address - Country:US
Practice Address - Phone:616-772-7010
Practice Address - Fax:616-772-7225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental