Provider Demographics
NPI:1699273706
Name:SMILECREATOR OF NAPLES LLC
Entity type:Organization
Organization Name:SMILECREATOR OF NAPLES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NILO
Authorized Official - Middle Name:ARTEMIO
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:239-692-7511
Mailing Address - Street 1:987 HIGH POINT DR STE 102
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3877
Mailing Address - Country:US
Mailing Address - Phone:239-564-3100
Mailing Address - Fax:
Practice Address - Street 1:987 HIGH POINT DR STE 102
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3877
Practice Address - Country:US
Practice Address - Phone:239-564-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-24
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental