# SMILES ON RANDOLPH PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295330587
- **Authorized official:** MS. DEE REMENIUS (ASSISTANT OFFICE MANAGER)
- **Authorized official phone:** (219) 980-0319

## Contact information

- **Practice address:** 8000 E LINCOLN HIGHWAY, MERRILLVILLE, IN 46410
- **Practice address phone:** (219) 769-6316
- **Practice address fax:** (219) 980-0379
- **Mailing address:** 6075 CLEVELAND CIR, MERRILLVILLE, IN 46410-2378
- **Mailing address phone:** (219) 980-0319
- **Mailing address fax:** (219) 980-0379

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 12/03/2020
- **Last updated:** 12/03/2020