Provider Demographics
NPI:1952581936
Name:MILES OF SMILES DENTAL CENTER, P.C.
Entity type:Organization
Organization Name:MILES OF SMILES DENTAL CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANA
Authorized Official - Middle Name:R
Authorized Official - Last Name:WARREN-BYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:256-539-3373
Mailing Address - Street 1:1636 PULASKI PIKE NW STE B
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35816-2534
Mailing Address - Country:US
Mailing Address - Phone:256-539-3373
Mailing Address - Fax:256-539-3365
Practice Address - Street 1:1636 PULASKI PIKE NW STE B
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35816-2534
Practice Address - Country:US
Practice Address - Phone:256-539-3373
Practice Address - Fax:256-539-3365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4890122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty