Organization
THE SMILE SHOP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT B SHACKLETTE DMD (OWNER)
(859) 223-7300
Entity
Organization
Contact information
Practice address
3650 BOSTON RD, SUITE K, LEXINGTON, KY 40514
(859) 223-7300
(859) 223-1122
Mailing address
3650 BOSTON RD, SUITE K, LEXINGTON, KY 40514
(859) 223-7300
(859) 223-1122
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3627
KY
Other
Enumeration date
10/26/2006
Last updated
08/22/2020
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