Provider Demographics
NPI:1932731114
Name:JUST RIGHT SMILES LLC
Entity Type:Organization
Organization Name:JUST RIGHT SMILES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DURHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-732-8923
Mailing Address - Street 1:5460 PONTIAC TRL
Mailing Address - Street 2:
Mailing Address - City:ORCHARD LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48323-1564
Mailing Address - Country:US
Mailing Address - Phone:954-732-8923
Mailing Address - Fax:
Practice Address - Street 1:11200 E MCNICHOLS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-3929
Practice Address - Country:US
Practice Address - Phone:313-521-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental