Provider Demographics
NPI:1427548353
Name:SIMPLY SMILE PA
Entity Type:Organization
Organization Name:SIMPLY SMILE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:HARPER
Authorized Official - Last Name:DAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:706-201-5205
Mailing Address - Street 1:7457 PATTERSON RD STE 107
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-0710
Mailing Address - Country:US
Mailing Address - Phone:803-807-2140
Mailing Address - Fax:803-647-1315
Practice Address - Street 1:7457 PATTERSON RD STE 107
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-0710
Practice Address - Country:US
Practice Address - Phone:803-807-2140
Practice Address - Fax:803-647-1315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8214261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental