Provider Demographics
NPI:1083010474
Name:HAPPY SMILES LLC
Entity Type:Organization
Organization Name:HAPPY SMILES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:E
Authorized Official - Last Name:STONER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-282-4279
Mailing Address - Street 1:30 COURTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-3124
Mailing Address - Country:US
Mailing Address - Phone:804-379-7855
Mailing Address - Fax:
Practice Address - Street 1:30 COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3124
Practice Address - Country:US
Practice Address - Phone:804-379-7855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-12
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010051431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty