Provider Demographics
NPI:1073113510
Name:GOTSMILE, INC
Entity Type:Organization
Organization Name:GOTSMILE, INC
Other - Org Name:GOT SMILE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:727-201-8700
Mailing Address - Street 1:180 4TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3445
Mailing Address - Country:US
Mailing Address - Phone:727-201-8700
Mailing Address - Fax:727-201-8714
Practice Address - Street 1:180 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3445
Practice Address - Country:US
Practice Address - Phone:727-201-8700
Practice Address - Fax:727-201-8714
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:N/A
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-26
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies