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Organization
SMILING CREATIONS, PA
Active
Organization
SMILING CREATIONS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY JAMES SMALL DMD (OWNER/DENTIST)
(904) 284-6688
Entity
Organization
Contact information
Practice address
708 SPRING ST, GREEN COVE SPRINGS, FL 32043-3318
(904) 284-6688
Mailing address
708 SPRING ST, GREEN COVE SPRINGS, FL 32043-3318
(904) 284-6688
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN0010981
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
072874800
—
FL
Enumeration date
02/15/2012
Last updated
02/15/2012
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