Provider Demographics
NPI:1437504693
Name:DENTISTRY MANAGEMENT SERVICES LLC
Entity Type:Organization
Organization Name:DENTISTRY MANAGEMENT SERVICES LLC
Other - Org Name:SMILE BY DESIGN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:HIRAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-346-9516
Mailing Address - Street 1:9250 HIGHWAY 5
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-1543
Mailing Address - Country:US
Mailing Address - Phone:770-942-1096
Mailing Address - Fax:
Practice Address - Street 1:9250 HIGHWAY 5
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-1543
Practice Address - Country:US
Practice Address - Phone:770-942-1096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty