Provider Demographics
NPI:1255178802
Name:TINSLEY SMILE SOLUTIONS LLC
Entity type:Organization
Organization Name:TINSLEY SMILE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ELISHEVA
Authorized Official - Middle Name:
Authorized Official - Last Name:TINSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:812-887-1481
Mailing Address - Street 1:18624 GRETNA GREEN LN
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-7997
Mailing Address - Country:US
Mailing Address - Phone:812-887-1481
Mailing Address - Fax:
Practice Address - Street 1:504 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1316
Practice Address - Country:US
Practice Address - Phone:812-887-1481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental