Provider Demographics
NPI:1649344649
Name:SMILES IN MOTION, P.C.
Entity type:Organization
Organization Name:SMILES IN MOTION, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STUFFLEBEAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:641-752-9550
Mailing Address - Street 1:207 E CHURCH ST
Mailing Address - Street 2:SUITE #3
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-2972
Mailing Address - Country:US
Mailing Address - Phone:641-752-9550
Mailing Address - Fax:641-752-9517
Practice Address - Street 1:207 E CHURCH ST
Practice Address - Street 2:SUITE #3
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-2972
Practice Address - Country:US
Practice Address - Phone:641-752-9550
Practice Address - Fax:641-752-9517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA080551223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0264416Medicaid
IA0264416Medicaid