The Smile Store

LBN: Palm Beach Gardens Ortho Location Llc
The Smile Store is an health care organization with primary practice located at 4362 Northlake Blvd Ste 114 , Palm Beach Gardens FL 33410-6269. The organization recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as the primary health care specialty. Palm Beach Gardens Ortho Location Llc can be contacted via phone (561) 658-4100, or through Cooper, Brenda via phone (561) 658-4100.

Contact Information

Primary practice address
4362 Northlake Blvd Ste 114 Palm Beach Gardens FL 33410-6269
Phone: (561) 658-4100
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Cooper, Brenda
Phone: (561) 658-4100

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X

Profile Details

NPI number 1518505692
LBN Legal business name Palm Beach Gardens Ortho Location Llc
DBA Doing business as The Smile Store
Authorized official Cooper, Brenda
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 19th, 2019
Last updated Jun 2nd, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518505692 NPPES
Florida MEDICAID 105737100

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