Provider Demographics
NPI:1013211309
Name:HEALTHYSMILES4HAPPY KIDS
Entity Type:Organization
Organization Name:HEALTHYSMILES4HAPPY KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-803-2904
Mailing Address - Street 1:1248 STONE HARBOUR RD
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-4739
Mailing Address - Country:US
Mailing Address - Phone:407-803-2904
Mailing Address - Fax:407-542-4634
Practice Address - Street 1:1248 STONE HARBOUR RD
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-4739
Practice Address - Country:US
Practice Address - Phone:407-803-2904
Practice Address - Fax:407-542-4634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-31
Last Update Date:2010-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12608122300000X
FLDH8826124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty