Provider Demographics
NPI:1023278165
Name:FAMILY SMILE CENTER, INC.
Entity type:Organization
Organization Name:FAMILY SMILE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVO HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:570-296-0300
Mailing Address - Street 1:201 W HARFORD ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-1127
Mailing Address - Country:US
Mailing Address - Phone:570-296-0300
Mailing Address - Fax:570-296-0302
Practice Address - Street 1:201 W HARFORD ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-1127
Practice Address - Country:US
Practice Address - Phone:570-296-0300
Practice Address - Fax:570-296-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0371721223G0001X
PADS0371601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty