Provider Demographics
NPI:1568530251
Name:SMILE DESIGN, LTD
Entity Type:Organization
Organization Name:SMILE DESIGN, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HORATIO
Authorized Official - Middle Name:DAN
Authorized Official - Last Name:ENACOPOL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-243-7645
Mailing Address - Street 1:15900 127TH ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-2910
Mailing Address - Country:US
Mailing Address - Phone:630-243-7645
Mailing Address - Fax:630-243-6336
Practice Address - Street 1:15900 127TH ST
Practice Address - Street 2:SUITE 211
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-2910
Practice Address - Country:US
Practice Address - Phone:630-243-7645
Practice Address - Fax:630-243-6336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental