Provider Demographics
NPI:1114965621
Name:RESTORING SMILES
Entity Type:Organization
Organization Name:RESTORING SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:CARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-871-4576
Mailing Address - Street 1:PO BOX 586
Mailing Address - Street 2:4780 INDUSTRIAL DRIVE
Mailing Address - City:MILLINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48746
Mailing Address - Country:US
Mailing Address - Phone:989-871-4576
Mailing Address - Fax:989-871-4585
Practice Address - Street 1:4780 INDUSTRIAL DRIVE
Practice Address - Street 2:
Practice Address - City:MILLINGTON
Practice Address - State:MI
Practice Address - Zip Code:48746
Practice Address - Country:US
Practice Address - Phone:989-871-4576
Practice Address - Fax:989-871-4585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901016238122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty