| Smileshack | |
|
9105 E 350 Raytown MO 64133-5718 | |
| (816) 533-6819 | |
| Not Available |
| Full Name | Smileshack |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 9105 E 350, Raytown, Missouri |
| Authorized Official Name and Position | James Ballou (OWNER) |
| Authorized Official Contact | 9726729279 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smileshack 9105 E 350 Raytown MO 64133-5718 Ph: (816) 533-6819 | Smileshack 9105 E 350 Raytown MO 64133-5718 Ph: (816) 533-6819 |
| NPI Number | 1437819646 |
|---|---|
| Provider Enumeration Date | 12/29/2021 |
| Last Update Date | 12/29/2021 |
| Certification Date | 12/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437819646 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | () | Primary |
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