Provider Demographics
NPI:1336850767
Name:SMILE DESIGN CENTRE
Entity Type:Organization
Organization Name:SMILE DESIGN CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAIMAA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAQAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:216-577-3121
Mailing Address - Street 1:50720 WOODFORD DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2878
Mailing Address - Country:US
Mailing Address - Phone:216-577-3121
Mailing Address - Fax:
Practice Address - Street 1:31700 TELEGRAPH RD STE 100
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-3466
Practice Address - Country:US
Practice Address - Phone:216-577-3121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental