Provider Demographics
NPI:1992895833
Name:ALL SMILES DENTAL CENTER INC
Entity type:Organization
Organization Name:ALL SMILES DENTAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:FISHER RANEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:225-775-3552
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70704-0421
Mailing Address - Country:US
Mailing Address - Phone:225-775-3552
Mailing Address - Fax:225-775-3569
Practice Address - Street 1:12841 PLANK ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714
Practice Address - Country:US
Practice Address - Phone:225-775-3552
Practice Address - Fax:225-775-3569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA48771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty