Provider Demographics
NPI:1649889387
Name:THE SMILE STUDIO
Entity type:Organization
Organization Name:THE SMILE STUDIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:MCEACHERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-929-8096
Mailing Address - Street 1:684 S LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48362-2918
Mailing Address - Country:US
Mailing Address - Phone:248-929-8096
Mailing Address - Fax:248-690-7911
Practice Address - Street 1:684 S LAPEER RD
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48362-2918
Practice Address - Country:US
Practice Address - Phone:248-929-8096
Practice Address - Fax:248-690-7911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty