Provider Demographics
NPI:1831384726
Name:ALL ABOUT SMILES DENTISTRY, P. C.
Entity type:Organization
Organization Name:ALL ABOUT SMILES DENTISTRY, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:WHITMIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-924-0660
Mailing Address - Street 1:PO BOX 1637
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74702-1637
Mailing Address - Country:US
Mailing Address - Phone:580-924-0660
Mailing Address - Fax:580-924-5376
Practice Address - Street 1:724 N. WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701
Practice Address - Country:US
Practice Address - Phone:580-924-0660
Practice Address - Fax:580-924-5376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK56621223G0001X
OK58721223G0001X
OK57161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty