Provider Demographics
NPI:1346739257
Name:BEAUTIFUL SMILES PLANTATION P.A.
Entity Type:Organization
Organization Name:BEAUTIFUL SMILES PLANTATION P.A.
Other - Org Name:DENTAL OFFICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-739-6464
Mailing Address - Street 1:1368 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-4734
Mailing Address - Country:US
Mailing Address - Phone:954-739-6464
Mailing Address - Fax:954-739-5210
Practice Address - Street 1:1368 NORTH UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-3332
Practice Address - Country:US
Practice Address - Phone:954-739-6464
Practice Address - Fax:954-739-6464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty