Provider Demographics
NPI:1437352986
Name:THE SMILE CENTER
Entity Type:Organization
Organization Name:THE SMILE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:F
Authorized Official - Middle Name:DON
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:865-945-5552
Mailing Address - Street 1:2205 CLINTON HWY
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-7606
Mailing Address - Country:US
Mailing Address - Phone:865-945-5552
Mailing Address - Fax:865-945-5554
Practice Address - Street 1:2205 CLINTON HWY
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-7606
Practice Address - Country:US
Practice Address - Phone:865-945-5552
Practice Address - Fax:865-945-5552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS3810122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN214560Medicaid