Provider Demographics
NPI:1407192164
Name:MEDFIELD SMILES PC
Entity Type:Organization
Organization Name:MEDFIELD SMILES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYMENT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-596-0297
Mailing Address - Street 1:2 SNOW HILL LN
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-1322
Mailing Address - Country:US
Mailing Address - Phone:508-596-0297
Mailing Address - Fax:
Practice Address - Street 1:16 PARK ST
Practice Address - Street 2:
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-2518
Practice Address - Country:US
Practice Address - Phone:508-359-2321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN193551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty