Provider Demographics
NPI:1932280237
Name:BEAUTIFUL SMILES FAMILY DENTISTRY, DDS, PC
Entity Type:Organization
Organization Name:BEAUTIFUL SMILES FAMILY DENTISTRY, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:JENKINS
Authorized Official - Last Name:DABNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-484-4051
Mailing Address - Street 1:8200 MALL PKWY
Mailing Address - Street 2:SUITE #155
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-6983
Mailing Address - Country:US
Mailing Address - Phone:770-484-4051
Mailing Address - Fax:770-484-4052
Practice Address - Street 1:8200 MALL PKWY
Practice Address - Street 2:SUITE #155
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-6983
Practice Address - Country:US
Practice Address - Phone:770-484-4051
Practice Address - Fax:770-484-4052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty