Organization
SMILES DENTAL GROUP, PC
Active
Other names
SMILES DENTAL GROUP, PC OR
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN TYLER SHOEMAKER D.M.D. (CHIEF DENTAL OFFICER)
(360) 261-6094
Entity
Organization
Contact information
Practice address
2245 MISSION ST SE, SALEM, OR 97302-1291
(360) 261-6094
(360) 423-3343
Mailing address
900 FIR ST, SUITE 1D, LONGVIEW, WA 98632-2544
(360) 261-6094
(360) 423-3343
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223D0004X
Dental Anesthesiology
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
122400000X
Denturist
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
02/17/2016
Last updated
02/17/2016
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