Provider Demographics
NPI:1982038782
Name:SMILING FACES OF BATON ROUGE LLC
Entity Type:Organization
Organization Name:SMILING FACES OF BATON ROUGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DR. TRACY
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:CREAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-621-7412
Mailing Address - Street 1:9321 BURBANK DR
Mailing Address - Street 2:SUITE 9323
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70820-8605
Mailing Address - Country:US
Mailing Address - Phone:504-621-7412
Mailing Address - Fax:
Practice Address - Street 1:9321 BURBANK DR
Practice Address - Street 2:SUITE 9323
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70820-8605
Practice Address - Country:US
Practice Address - Phone:504-621-7412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty