Provider Demographics
NPI:1417522533
Name:ARNOLD SMILES DENTAL LLC
Entity Type:Organization
Organization Name:ARNOLD SMILES DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARISCAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:636-464-6444
Mailing Address - Street 1:124 RICHARDSON XING
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-6023
Mailing Address - Country:US
Mailing Address - Phone:364-646-4446
Mailing Address - Fax:
Practice Address - Street 1:124 RICHARDSON XING
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010-6023
Practice Address - Country:US
Practice Address - Phone:364-646-4446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARNOLD SMILES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty