Provider Demographics
NPI:1215226592
Name:SMILE AGAIN LLC
Entity Type:Organization
Organization Name:SMILE AGAIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TALAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ASWAD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-659-2943
Mailing Address - Street 1:2745 S. ALMA SCHOOL ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286
Mailing Address - Country:US
Mailing Address - Phone:480-659-2943
Mailing Address - Fax:
Practice Address - Street 1:2745 S. ALMA SCHOOL ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286
Practice Address - Country:US
Practice Address - Phone:480-659-2943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5719122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty