Provider Demographics
NPI:1245400183
Name:JUST SMILES, INC.
Entity Type:Organization
Organization Name:JUST SMILES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:RESNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-368-2222
Mailing Address - Street 1:7054 E COCHISE RD
Mailing Address - Street 2:B-215
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-4546
Mailing Address - Country:US
Mailing Address - Phone:480-368-2222
Mailing Address - Fax:480-369-6139
Practice Address - Street 1:7054 E COCHISE RD
Practice Address - Street 2:B-215
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253-4546
Practice Address - Country:US
Practice Address - Phone:480-368-2222
Practice Address - Fax:480-369-6139
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. STEPHEN BRIAN RESNICK DMD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ50901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty