Provider Demographics
NPI:1891439832
Name:SMILE KEEPERS
Entity Type:Organization
Organization Name:SMILE KEEPERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-725-5223
Mailing Address - Street 1:221 E NORTH ST
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-1820
Mailing Address - Country:US
Mailing Address - Phone:989-725-5223
Mailing Address - Fax:989-723-4400
Practice Address - Street 1:221 E NORTH ST
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-1820
Practice Address - Country:US
Practice Address - Phone:989-725-5223
Practice Address - Fax:989-723-4400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-26
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental