Provider Demographics
NPI:1922124767
Name:SMILEBUILDERZ LLC
Entity Type:Organization
Organization Name:SMILEBUILDERZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:P
Authorized Official - Last Name:SKIADAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-481-7645
Mailing Address - Street 1:204 BUTLER AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6307
Mailing Address - Country:US
Mailing Address - Phone:717-481-7645
Mailing Address - Fax:717-481-7655
Practice Address - Street 1:1685 CROWN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6310
Practice Address - Country:US
Practice Address - Phone:717-481-7645
Practice Address - Fax:717-481-7655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS036610122300000X
PADS036800122300000X
PADS018166I122300000X
PADS027910L122300000X
PADS029837L122300000X
122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty