Provider Demographics
NPI:1861240210
Name:STUDIO SMILES
Entity type:Organization
Organization Name:STUDIO SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ALAA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANBARI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:313-603-6130
Mailing Address - Street 1:1625 BRANDYWINE DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-1109
Mailing Address - Country:US
Mailing Address - Phone:313-603-6130
Mailing Address - Fax:
Practice Address - Street 1:4468 W WALTON BLVD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48329-4098
Practice Address - Country:US
Practice Address - Phone:313-603-6130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental