Provider Demographics
NPI:1487030276
Name:SMILE FOREVER DENTISTRY
Entity Type:Organization
Organization Name:SMILE FOREVER DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-484-1010
Mailing Address - Street 1:8890 MCDONOGH ROAD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-0000
Mailing Address - Country:US
Mailing Address - Phone:410-484-1010
Mailing Address - Fax:410-486-8939
Practice Address - Street 1:8890 MCDONOGH ROAD
Practice Address - Street 2:SUITE 315
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-0000
Practice Address - Country:US
Practice Address - Phone:410-484-1010
Practice Address - Fax:410-486-8939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental