Provider Demographics
NPI:1972204733
Name:DELICATE SMILES LLC
Entity type:Organization
Organization Name:DELICATE SMILES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSHEHABI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-577-0282
Mailing Address - Street 1:2728 RED FAWN CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53406-1754
Mailing Address - Country:US
Mailing Address - Phone:703-577-0282
Mailing Address - Fax:
Practice Address - Street 1:200 W SILVER SPRING DR STE 320
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53217-5059
Practice Address - Country:US
Practice Address - Phone:414-332-1808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental