Provider Demographics
NPI:1144607474
Name:LAVON SMILES, PLLC
Entity Type:Organization
Organization Name:LAVON SMILES, PLLC
Other - Org Name:SMART MOUTH FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAPER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:844-408-9750
Mailing Address - Street 1:440 STATE HIGHWAY 78 STE 200
Mailing Address - Street 2:
Mailing Address - City:LAVON
Mailing Address - State:TX
Mailing Address - Zip Code:75166-1266
Mailing Address - Country:US
Mailing Address - Phone:844-408-9750
Mailing Address - Fax:903-465-1134
Practice Address - Street 1:440 STATE HIGHWAY 78 STE 200
Practice Address - Street 2:
Practice Address - City:LAVON
Practice Address - State:TX
Practice Address - Zip Code:75166-1266
Practice Address - Country:US
Practice Address - Phone:844-408-9750
Practice Address - Fax:903-465-1134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30271122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty