Provider Demographics
NPI:1407246341
Name:SMILE ARTS LLC
Entity type:Organization
Organization Name:SMILE ARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DHYLLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-631-6611
Mailing Address - Street 1:400 ROCKBOURNE BLVD, SUITE 400
Mailing Address - Street 2:
Mailing Address - City:CLIFTON HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:19018-1739
Mailing Address - Country:US
Mailing Address - Phone:484-461-7142
Mailing Address - Fax:484-461-7007
Practice Address - Street 1:400 ROCKBOURNE BLVD, SUITE 400
Practice Address - Street 2:
Practice Address - City:CLIFTON HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:19018-1739
Practice Address - Country:US
Practice Address - Phone:484-461-7142
Practice Address - Fax:484-461-7007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0382451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty