Provider Demographics
NPI:1780976019
Name:SILLY SMILES, LLC
Entity type:Organization
Organization Name:SILLY SMILES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:R
Authorized Official - Last Name:COPES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:302-838-1865
Mailing Address - Street 1:200 BIDDLE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-3968
Mailing Address - Country:US
Mailing Address - Phone:302-838-1865
Mailing Address - Fax:302-838-7193
Practice Address - Street 1:200 BIDDLE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-3968
Practice Address - Country:US
Practice Address - Phone:302-838-1865
Practice Address - Fax:302-838-7193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00012581223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty