Provider Demographics
NPI:1629491568
Name:AFFORDABLE SMILES INC.
Entity Type:Organization
Organization Name:AFFORDABLE SMILES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LEVI
Authorized Official - Middle Name:LEVI
Authorized Official - Last Name:EVALT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:814-664-2012
Mailing Address - Street 1:209 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:CORRY
Mailing Address - State:PA
Mailing Address - Zip Code:16407-1626
Mailing Address - Country:US
Mailing Address - Phone:814-664-2012
Mailing Address - Fax:814-664-2017
Practice Address - Street 1:209 N CENTER ST
Practice Address - Street 2:
Practice Address - City:CORRY
Practice Address - State:PA
Practice Address - Zip Code:16407-1626
Practice Address - Country:US
Practice Address - Phone:814-664-2012
Practice Address - Fax:814-664-2017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty