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FAYETTEVILLE SMILES DENTISTRY PC NPI 1912303413


NPI Information

NPI: 1912303413
Provider Name: FAYETTEVILLE SMILES DENTISTRY, PC

Doing Business As: FAYETTEVILLE SMILES DENTISTRY

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 11D2216883

Address:
117 PAVILION PKWY
SUITE 15B
FAYETTEVILLE, GA
ZIP 30214
Phone: (770) 953-6975
Get Directions

FAYETTEVILLE SMILES DENTISTRY, PC is a general practice dentist in Fayetteville, GA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. FAYETTEVILLE SMILES DENTISTRY, PC NPI is 1912303413. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Fayetteville Smiles Dentistry.

The provider's business location address is:

117 PAVILION PKWY
SUITE 15B
FAYETTEVILLE, GA
ZIP 30214-732
Phone: (770) 953-6975
Fax: (770) 953-6979

The provider's authorized official is Katie L Mccann .
The authorized official title is Owner and has the following contact phone number (770) 953-6975.

The CLIA number assigned to this NPI record is 11D2216883 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/10/2014 and was last updated on 11/10/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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