Provider Demographics
NPI:1134877848
Name:SMILE AT LIFE DENTISTRY, PLLC
Entity type:Organization
Organization Name:SMILE AT LIFE DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:425-248-5439
Mailing Address - Street 1:42551 WHITMAN WAY
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2727
Mailing Address - Country:US
Mailing Address - Phone:425-248-5439
Mailing Address - Fax:
Practice Address - Street 1:32905 W 12 MILE RD STE 120
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3343
Practice Address - Country:US
Practice Address - Phone:248-553-3553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental