Provider Demographics
NPI:1497170500
Name:SMILE AMERICA
Entity Type:Organization
Organization Name:SMILE AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-843-7073
Mailing Address - Street 1:626 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:VA
Mailing Address - Zip Code:21318
Mailing Address - Country:US
Mailing Address - Phone:804-843-7073
Mailing Address - Fax:
Practice Address - Street 1:626 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:VA
Practice Address - Zip Code:23181
Practice Address - Country:US
Practice Address - Phone:804-843-7073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty