Provider Demographics
NPI:1942210836
Name:MOHR & MOHR SMILES PC
Entity Type:Organization
Organization Name:MOHR & MOHR SMILES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER VP
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOHR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:765-463-9505
Mailing Address - Street 1:2950 US HIGHWAY 52 W
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906
Mailing Address - Country:US
Mailing Address - Phone:765-463-9505
Mailing Address - Fax:765-497-1744
Practice Address - Street 1:2950 US HIGHWAY 52 W
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906
Practice Address - Country:US
Practice Address - Phone:765-463-9505
Practice Address - Fax:765-497-1744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010501A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty