Provider Demographics
NPI:1629552377
Name:SHARP SMILES, LLC
Entity Type:Organization
Organization Name:SHARP SMILES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:912-882-2005
Mailing Address - Street 1:206 ARNOW DR
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-4071
Mailing Address - Country:US
Mailing Address - Phone:912-882-2005
Mailing Address - Fax:912-882-2342
Practice Address - Street 1:206 ARNOW DR
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-4071
Practice Address - Country:US
Practice Address - Phone:912-882-2005
Practice Address - Fax:912-882-2342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental