Provider Demographics
NPI:1336597608
Name:PERFECT SMILES
Entity Type:Organization
Organization Name:PERFECT SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-214-3098
Mailing Address - Street 1:3416 W LASKEY RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4015
Mailing Address - Country:US
Mailing Address - Phone:419-214-3098
Mailing Address - Fax:419-473-9995
Practice Address - Street 1:3416 W LASKEY RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4015
Practice Address - Country:US
Practice Address - Phone:419-214-3098
Practice Address - Fax:419-473-9995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH21096122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty