Provider Demographics
NPI:1790346401
Name:ARTISTIC SMILES DENTISTRY
Entity Type:Organization
Organization Name:ARTISTIC SMILES DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:CZOCHANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-639-6181
Mailing Address - Street 1:2606 E. CHAPMAN AVE.
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869
Mailing Address - Country:US
Mailing Address - Phone:714-639-6181
Mailing Address - Fax:714-639-6181
Practice Address - Street 1:2606 E. CHAPMAN AVE.
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869
Practice Address - Country:US
Practice Address - Phone:714-639-6181
Practice Address - Fax:714-639-6181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental