# THE SMILE SHOP INC

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

## Provider details

- **NPI number:** 1336224484
- **Authorized official:** ROBERT B SHACKLETTE DMD (OWNER)
- **Authorized official phone:** (859) 223-7300

## Contact information

- **Practice address:** 3650 BOSTON RD, SUITE K, LEXINGTON, KY 40514
- **Practice address phone:** (859) 223-7300
- **Practice address fax:** (859) 223-1122
- **Mailing address:** 3650 BOSTON RD, SUITE K, LEXINGTON, KY 40514
- **Mailing address phone:** (859) 223-7300
- **Mailing address fax:** (859) 223-1122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3627 | KY | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 08/22/2020