Provider Demographics
NPI:1235247719
Name:ARLINGTON SMITH FAMILY DENTISTRY LTD
Entity Type:Organization
Organization Name:ARLINGTON SMITH FAMILY DENTISTRY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-392-4341
Mailing Address - Street 1:2101 S ARLINGTON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4185
Mailing Address - Country:US
Mailing Address - Phone:847-357-3899
Mailing Address - Fax:847-357-8195
Practice Address - Street 1:2101 S ARLINGTON HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4185
Practice Address - Country:US
Practice Address - Phone:847-357-3899
Practice Address - Fax:847-357-8195
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARLINGTON SMITH FAMILY DENTISTRY LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-26
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019023315122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty