Provider Demographics
NPI:1922535079
Name:MILES OF SMILES DENTAL GROUP
Entity Type:Organization
Organization Name:MILES OF SMILES DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:O'KANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-344-5838
Mailing Address - Street 1:701 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:IOWA FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50126-2100
Mailing Address - Country:US
Mailing Address - Phone:641-648-4293
Mailing Address - Fax:
Practice Address - Street 1:701 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:IOWA FALLS
Practice Address - State:IA
Practice Address - Zip Code:50126-2100
Practice Address - Country:US
Practice Address - Phone:641-648-4293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental