Provider Demographics
NPI:1215727748
Name:SMILE BELLEFONTAINE INC
Entity type:Organization
Organization Name:SMILE BELLEFONTAINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUPREETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:VEERESH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-974-8133
Mailing Address - Street 1:139 W SANDUSKY AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-1415
Mailing Address - Country:US
Mailing Address - Phone:937-230-5868
Mailing Address - Fax:
Practice Address - Street 1:139 W SANDUSKY AVE
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-1415
Practice Address - Country:US
Practice Address - Phone:937-230-5868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty