Organization
SMILES DENTAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACOB A LEWIS CPA, MBA (CFO)
(206) 919-6578
Entity
Organization
Contact information
Practice address
1018 N BOONES FERRY RD, WOODBURN, OR 97071-9602
(503) 981-1841
(503) 981-7334
Mailing address
820 OCEAN BEACH HWY, STE 110, LONGVIEW, WA 98632-4080
(503) 981-1841
(503) 981-7334
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
D8230
OR
Other
Enumeration date
06/17/2014
Last updated
06/17/2014
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