Provider Demographics
NPI:1528223393
Name:SMILES AT THE EXCHANGE
Entity Type:Organization
Organization Name:SMILES AT THE EXCHANGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRABILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-433-5133
Mailing Address - Street 1:9100 MARKETPLACE DR
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-4671
Mailing Address - Country:US
Mailing Address - Phone:937-433-5133
Mailing Address - Fax:937-433-9984
Practice Address - Street 1:9100 MARKETPLACE DR
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-4671
Practice Address - Country:US
Practice Address - Phone:937-433-5133
Practice Address - Fax:937-433-9984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13207122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty