Provider Demographics
NPI:1992189658
Name:ISMILE PC
Entity Type:Organization
Organization Name:ISMILE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HAN
Authorized Official - Middle Name:SOO
Authorized Official - Last Name:LHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-233-1189
Mailing Address - Street 1:347 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-2443
Mailing Address - Country:US
Mailing Address - Phone:781-233-1189
Mailing Address - Fax:
Practice Address - Street 1:101 PLEASANT ST
Practice Address - Street 2:SUITE 210
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-3213
Practice Address - Country:US
Practice Address - Phone:781-233-1189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental