Provider Demographics
NPI:1942511316
Name:TOTAL SMILES DENTAL GROUP
Entity Type:Organization
Organization Name:TOTAL SMILES DENTAL GROUP
Other - Org Name:TOTAL SMILES DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SCHERR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-475-7303
Mailing Address - Street 1:901 TAYLOR ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-2301
Mailing Address - Country:US
Mailing Address - Phone:734-475-7303
Mailing Address - Fax:734-433-4270
Practice Address - Street 1:901 TAYLOR ST
Practice Address - Street 2:SUITE A
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-2301
Practice Address - Country:US
Practice Address - Phone:734-475-7303
Practice Address - Fax:734-433-4270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI115584254881223G0001X
MI15180298831223G0001X
MI29010180781223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty