Provider Demographics
NPI:1780214031
Name:FRANKENMUTH SMILES PLLC
Entity Type:Organization
Organization Name:FRANKENMUTH SMILES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:JULIE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-652-6461
Mailing Address - Street 1:526 W GENESEE ST STE 4
Mailing Address - Street 2:
Mailing Address - City:FRANKENMUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48734-1357
Mailing Address - Country:US
Mailing Address - Phone:989-652-6461
Mailing Address - Fax:
Practice Address - Street 1:526 W GENESEE ST STE 4
Practice Address - Street 2:
Practice Address - City:FRANKENMUTH
Practice Address - State:MI
Practice Address - Zip Code:48734-1357
Practice Address - Country:US
Practice Address - Phone:989-652-6461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty