Provider Demographics
NPI:1427129162
Name:SMILES ON TRINDLE DENTAL CARE
Entity type:Organization
Organization Name:SMILES ON TRINDLE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:COBLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-697-4606
Mailing Address - Street 1:4805 E TRINDLE RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-3510
Mailing Address - Country:US
Mailing Address - Phone:717-697-4606
Mailing Address - Fax:717-697-0573
Practice Address - Street 1:4805 E TRINDLE RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-3510
Practice Address - Country:US
Practice Address - Phone:717-697-4606
Practice Address - Fax:717-697-0573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000159938OtherHIGHMARK