Provider Demographics
NPI:1134901952
Name:LEXINGTON FAMILY SMILES
Entity type:Organization
Organization Name:LEXINGTON FAMILY SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:803-951-0991
Mailing Address - Street 1:1000 TOWNE CENTER BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-4508
Mailing Address - Country:US
Mailing Address - Phone:912-748-8585
Mailing Address - Fax:
Practice Address - Street 1:2001 AUGUSTA HWY STE B
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-1927
Practice Address - Country:US
Practice Address - Phone:803-951-0991
Practice Address - Fax:803-951-0995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty