Provider Demographics
NPI:1043313281
Name:SMART DENTAL HOLDINGS, LLC
Entity Type:Organization
Organization Name:SMART DENTAL HOLDINGS, LLC
Other - Org Name:MCCALLA DENTAL
Other - Org Type:Other Name
Authorized Official - Title/Position:REVENUE CYCLE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-477-4242
Mailing Address - Street 1:5751 POCAHONTAS ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-5478
Mailing Address - Country:US
Mailing Address - Phone:205-477-4242
Mailing Address - Fax:205-477-4243
Practice Address - Street 1:5751 POCAHONTAS ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-5478
Practice Address - Country:US
Practice Address - Phone:205-477-4242
Practice Address - Fax:205-477-4243
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCCALLA FAMILY DENTISTRY, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-06
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL53451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty