NPI 1285844274 · live from the CMS NPI Registry
A Smile Resort, PA
Dentist, General Practice in Jacksonville, FL. National Provider Identifier 1285844274, active.
NPI record
| NPI | 1285844274 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 3676 Crown Point Ct, Jacksonville, FL 32257 |
| Practice phone | 904-268-2011 |
| Enumerated | May 22, 2007 |
| Last updated | August 22, 2020 |
| Authorized official | Martha Lay, Office Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice | 1223G0001X | DN16658 (FL) |
| Dentist, General Practice primary | 1223G0001X | DN0010421 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.