Provider Demographics
NPI:1427280163
Name:THE SMILE INSTITUTE, LTD.
Entity type:Organization
Organization Name:THE SMILE INSTITUTE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:612-240-5067
Mailing Address - Street 1:14711 FRYELANDS BLVD SE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-2944
Mailing Address - Country:US
Mailing Address - Phone:612-240-5067
Mailing Address - Fax:
Practice Address - Street 1:14711 FRYELANDS BLVD SE
Practice Address - Street 2:SUITE 111
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-2944
Practice Address - Country:US
Practice Address - Phone:612-240-5067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60083251261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental