Provider Demographics
NPI:1730646886
Name:SMILES FOR KIDS NORCROSS PC
Entity Type:Organization
Organization Name:SMILES FOR KIDS NORCROSS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JYOTI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:404-668-1155
Mailing Address - Street 1:5140 BEECHAM CT
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-3390
Mailing Address - Country:US
Mailing Address - Phone:404-668-1155
Mailing Address - Fax:
Practice Address - Street 1:3953 HOLCOMB BRIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-5201
Practice Address - Country:US
Practice Address - Phone:678-969-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty