Provider Demographics
NPI:1811161409
Name:SIMPLY CHILDRENS DENTISTRY INC
Entity type:Organization
Organization Name:SIMPLY CHILDRENS DENTISTRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMITI
Authorized Official - Middle Name:U
Authorized Official - Last Name:HARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:912-353-9993
Mailing Address - Street 1:613 STEPHENSON AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405
Mailing Address - Country:US
Mailing Address - Phone:912-353-9993
Mailing Address - Fax:912-353-9995
Practice Address - Street 1:613 STEPHENSON AVENUE
Practice Address - Street 2:SUITE 201
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405
Practice Address - Country:US
Practice Address - Phone:912-353-9993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIMPLY CHILDRENS DENTISTRY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0128971223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty