Provider Demographics
NPI:1275315269
Name:CLINICA SONRISAS LLC
Entity Type:Organization
Organization Name:CLINICA SONRISAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-842-0165
Mailing Address - Street 1:4803 HIXSON PIKE STE 101
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4486
Mailing Address - Country:US
Mailing Address - Phone:423-842-0165
Mailing Address - Fax:
Practice Address - Street 1:1148 E 23RD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-2213
Practice Address - Country:US
Practice Address - Phone:423-760-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty