Provider Demographics
NPI:1346754785
Name:ATLAS SMILES, PLLC
Entity Type:Organization
Organization Name:ATLAS SMILES, PLLC
Other - Org Name:ATLAS SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-444-8569
Mailing Address - Street 1:12331 SW 3RD ST STE 450
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33325-2813
Mailing Address - Country:US
Mailing Address - Phone:954-604-6777
Mailing Address - Fax:954-604-6777
Practice Address - Street 1:12331 SW 3RD ST STE 450
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33325-2813
Practice Address - Country:US
Practice Address - Phone:954-604-6777
Practice Address - Fax:954-604-6777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-21
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20898122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty