The Smile Shop INC

NPI #1336224484 in Lexington, Kentucky

Provider Information

NPI Number: 1336224484
Entity Type: Organization
Organization Name: The Smile Shop INC
Primary Specialty: Dentist
Enumeration Date: Oct 26, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 3650 BOSTON RD
Address 2: SUITE K
City: Lexington
State: Kentucky
ZIP Code: 40514
Phone: (859) 223-7300

Authorized Official

Name: ROBERT B SHACKLETTE, DMD
Title: OWNER
Phone: (859) 223-7300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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