Provider Demographics
NPI:1275257164
Name:OAK PARK SMILES
Entity Type:Organization
Organization Name:OAK PARK SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VARO
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-422-5433
Mailing Address - Street 1:346 KANAN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-1165
Mailing Address - Country:US
Mailing Address - Phone:818-889-2254
Mailing Address - Fax:
Practice Address - Street 1:346 KANAN RD STE 101
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:CA
Practice Address - Zip Code:91377-1165
Practice Address - Country:US
Practice Address - Phone:818-889-2254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty