Provider Demographics
NPI:1841709953
Name:HEALTHY SMILES
Entity type:Organization
Organization Name:HEALTHY SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:OATES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-268-2093
Mailing Address - Street 1:53 W MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-1109
Mailing Address - Country:US
Mailing Address - Phone:248-268-2093
Mailing Address - Fax:
Practice Address - Street 1:53 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-1109
Practice Address - Country:US
Practice Address - Phone:248-268-2093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901016829122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty