Provider Demographics
NPI:1265763296
Name:SMILEGUYS, PLLC
Entity type:Organization
Organization Name:SMILEGUYS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:W.
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-385-2273
Mailing Address - Street 1:4044 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT GRATIOT
Mailing Address - State:MI
Mailing Address - Zip Code:48059-3800
Mailing Address - Country:US
Mailing Address - Phone:810-385-2273
Mailing Address - Fax:
Practice Address - Street 1:1100 MICHIGAN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MARYSVILLE
Practice Address - State:MI
Practice Address - Zip Code:48040-2112
Practice Address - Country:US
Practice Address - Phone:810-364-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI16113122300000X
MI16735122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty