Provider Demographics
NPI:1417108432
Name:A BETTER SMILE, PC
Entity Type:Organization
Organization Name:A BETTER SMILE, PC
Other - Org Name:DANA ROSS, PC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:BRANDEE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:SPILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:918-346-1900
Mailing Address - Street 1:1201 E 42ND PL
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-3849
Mailing Address - Country:US
Mailing Address - Phone:918-346-1900
Mailing Address - Fax:918-347-5748
Practice Address - Street 1:3902 S 113TH WEST AVE
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-2724
Practice Address - Country:US
Practice Address - Phone:918-245-5800
Practice Address - Fax:918-245-5803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK57001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty