Provider Demographics
NPI: | 1861836157 |
---|---|
Name: | SMILES TO YOU, PLLC |
Entity Type: | Organization |
Organization Name: | SMILES TO YOU, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | KATHERINE |
Authorized Official - Middle Name: | FITCHETT |
Authorized Official - Last Name: | REYNOLDS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RDH |
Authorized Official - Phone: | 757-927-2238 |
Mailing Address - Street 1: | 591 BLOUNT POINT RD |
Mailing Address - Street 2: | |
Mailing Address - City: | NEWPORT NEWS |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 23606-2066 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 757-927-2238 |
Mailing Address - Fax: | 757-223-4809 |
Practice Address - Street 1: | 591 BLOUNT POINT RD |
Practice Address - Street 2: | |
Practice Address - City: | NEWPORT NEWS |
Practice Address - State: | VA |
Practice Address - Zip Code: | 23606-2066 |
Practice Address - Country: | US |
Practice Address - Phone: | 757-927-2238 |
Practice Address - Fax: | 757-223-4809 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-04-17 |
Last Update Date: | 2013-04-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
VA | 0443000009 | 261QD0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QD0000X | Ambulatory Health Care Facilities | Clinic/Center | Dental |