Provider Demographics
NPI:1689193294
Name:SNC DENTAL, PC
Entity Type:Organization
Organization Name:SNC DENTAL, PC
Other - Org Name:SUNNY SMILES FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:BANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-505-1111
Mailing Address - Street 1:3913 LEBANON PIKE
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2011
Mailing Address - Country:US
Mailing Address - Phone:615-505-1111
Mailing Address - Fax:615-905-1111
Practice Address - Street 1:3913 LEBANON PIKE
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2011
Practice Address - Country:US
Practice Address - Phone:615-505-1111
Practice Address - Fax:615-905-1111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9233261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental