Provider Demographics
NPI:1255180253
Name:RICHMOND SMILE DESIGNS, LLC
Entity type:Organization
Organization Name:RICHMOND SMILE DESIGNS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CALITRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-623-3818
Mailing Address - Street 1:311 RADIO PARK DR STE B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2399
Mailing Address - Country:US
Mailing Address - Phone:859-623-3818
Mailing Address - Fax:859-624-1061
Practice Address - Street 1:311 RADIO PARK DR STE B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2399
Practice Address - Country:US
Practice Address - Phone:859-623-3818
Practice Address - Fax:859-624-1061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental