Provider Demographics
NPI:1144843939
Name:SMILE MARIANAS, INC.
Entity type:Organization
Organization Name:SMILE MARIANAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:FLOR
Authorized Official - Middle Name:R
Authorized Official - Last Name:URENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:670-235-2378
Mailing Address - Street 1:PMB 121 BOX 10001
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950
Mailing Address - Country:US
Mailing Address - Phone:670-235-2378
Mailing Address - Fax:
Practice Address - Street 1:SAN JOSE
Practice Address - Street 2:CDA BUILDING
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950-9695
Practice Address - Country:US
Practice Address - Phone:670-235-2378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental