| The Smile Store | |
|
4362 Northlake Blvd Ste 114 Palm Beach Gardens FL 33410-6269 | |
| (561) 658-4100 | |
| Not Available |
| Full Name | The Smile Store |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 4362 Northlake Blvd Ste 114, Palm Beach Gardens, Florida |
| Authorized Official Name and Position | Brenda Cooper (INSURANCE COORDINATOR) |
| Authorized Official Contact | 5616584100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Smile Store 4362 Northlake Blvd Ste 114 Palm Beach Gardens FL 33410-6269 Ph: (561) 658-4100 | The Smile Store 4362 Northlake Blvd Ste 114 Palm Beach Gardens FL 33410-6269 Ph: (561) 658-4100 |
| NPI Number | 1518505692 |
|---|---|
| Provider Enumeration Date | 12/19/2019 |
| Last Update Date | 06/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518505692 | NPI | - | NPPES |
| 105737100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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