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Organization
SMILES ON 16TH PLLC
Active
Organization
SMILES ON 16TH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW CROUCH (VP)
(321) 872-8820
Entity
Organization
Contact information
Practice address
5200 16TH ST N, ST PETERSBURG, FL 33703-2612
(727) 522-9192
Mailing address
5200 16TH ST N, ST PETERSBURG, FL 33703-2612
(727) 522-9192
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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