Organization
EYES WYDE SHUT II, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KINENA DENT SMITH (OWNER)
(980) 777-0801
Entity
Organization
Contact information
Practice address
1964 SLIPPERY ROCK LN, MONROE, NC 28112-0005
(980) 777-0801
Mailing address
1964 SLIPPERY ROCK LN, MONROE, NC 28112-0005
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/26/2025
Last updated
12/26/2025
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