Provider Demographics
NPI:1659024966
Name:FOR WORLD WIDE SMILES
Entity Type:Organization
Organization Name:FOR WORLD WIDE SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAHARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-649-0181
Mailing Address - Street 1:5122 OLYMPIC DR STE A101
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1768
Mailing Address - Country:US
Mailing Address - Phone:253-649-0181
Mailing Address - Fax:253-313-5892
Practice Address - Street 1:5122 OLYMPIC DR STE A101
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1768
Practice Address - Country:US
Practice Address - Phone:253-649-0181
Practice Address - Fax:253-313-5892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental