Provider Demographics
NPI:1841431780
Name:SIMPLY SMILES INC.
Entity Type:Organization
Organization Name:SIMPLY SMILES INC.
Other - Org Name:SIMPLY SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHRAMM
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:734-845-6659
Mailing Address - Street 1:11510 CLEMENT RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGPORT
Mailing Address - State:MI
Mailing Address - Zip Code:49284-9713
Mailing Address - Country:US
Mailing Address - Phone:734-845-6659
Mailing Address - Fax:517-857-4297
Practice Address - Street 1:11510 CLEMENT RD
Practice Address - Street 2:
Practice Address - City:SPRINGPORT
Practice Address - State:MI
Practice Address - Zip Code:49284-9713
Practice Address - Country:US
Practice Address - Phone:734-845-6659
Practice Address - Fax:517-857-4297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-22
Last Update Date:2009-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901011615251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare