Provider Demographics
NPI:1013316504
Name:GR8 SMILES PLLC
Entity Type:Organization
Organization Name:GR8 SMILES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROHIT
Authorized Official - Middle Name:
Authorized Official - Last Name:NARAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-946-9375
Mailing Address - Street 1:501 EAST STATE. RD.
Mailing Address - Street 2:114
Mailing Address - City:LEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 EAST STATE. RD.
Practice Address - Street 2:114
Practice Address - City:LEVELAND
Practice Address - State:TX
Practice Address - Zip Code:79336
Practice Address - Country:US
Practice Address - Phone:423-946-9375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty