Provider Demographics
NPI:1376027862
Name:AFFORDABLE SMILES PLLC
Entity Type:Organization
Organization Name:AFFORDABLE SMILES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TATHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-855-4201
Mailing Address - Street 1:7003 SHALLOWFORD RD STE 201
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-6722
Mailing Address - Country:US
Mailing Address - Phone:423-855-4201
Mailing Address - Fax:423-855-4203
Practice Address - Street 1:7003 SHALLOWFORD RD STE 201
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-6722
Practice Address - Country:US
Practice Address - Phone:423-855-4201
Practice Address - Fax:423-855-4203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty