Provider Demographics
NPI:1689279416
Name:FAMILY SMILES DENTAL CARE
Entity Type:Organization
Organization Name:FAMILY SMILES DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MATIEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-853-2222
Mailing Address - Street 1:2064 W AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-3628
Mailing Address - Country:US
Mailing Address - Phone:248-853-2222
Mailing Address - Fax:248-853-6010
Practice Address - Street 1:2064 W AUBURN RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-3628
Practice Address - Country:US
Practice Address - Phone:248-853-2222
Practice Address - Fax:248-853-6010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty