| Organization Name: | MARTINSVILLE SMILES, PLLC |
| NPI Number: | 1114229614 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK A CRABTREE (MANAGING MEMBER) |
| Mailing Address: | 407 Starling Ave Martinsville |
| State: | VA US |
| Postal Code: | 241123731 |
| Phone Number: | 2766329266 |
| Fax Number: | 2766322341 |
| NPI Enumeration Date: | 12/03/2010 |
| NPI Last Update Date: | 12/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |