Provider Demographics
NPI:1487242384
Name:SMILE STUDIO OF FARMINGTON HILLS, PC
Entity type:Organization
Organization Name:SMILE STUDIO OF FARMINGTON HILLS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SORIAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-229-2274
Mailing Address - Street 1:14755 NORTHLINE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-2407
Mailing Address - Country:US
Mailing Address - Phone:734-281-0880
Mailing Address - Fax:
Practice Address - Street 1:32931 MIDDLEBELT RD STE 612
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1772
Practice Address - Country:US
Practice Address - Phone:248-626-9915
Practice Address - Fax:248-851-0843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-06
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty