Provider Demographics
NPI:1801068291
Name:ISMILE LLC
Entity type:Organization
Organization Name:ISMILE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-297-3992
Mailing Address - Street 1:1230 UPPER HEMBREE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-0911
Mailing Address - Country:US
Mailing Address - Phone:678-297-3992
Mailing Address - Fax:678-297-3998
Practice Address - Street 1:1230 UPPER HEMBREE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-0911
Practice Address - Country:US
Practice Address - Phone:678-297-3992
Practice Address - Fax:678-297-3998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0128241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty