Provider Demographics
NPI:1952951303
Name:SWEET CITY SMILES
Entity Type:Organization
Organization Name:SWEET CITY SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUONG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:678-643-1488
Mailing Address - Street 1:5019 W BROAD ST STE M213
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-0006
Mailing Address - Country:US
Mailing Address - Phone:470-655-6888
Mailing Address - Fax:470-655-6889
Practice Address - Street 1:5019 W BROAD ST STE M213
Practice Address - Street 2:
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-0006
Practice Address - Country:US
Practice Address - Phone:470-655-6888
Practice Address - Fax:470-655-6889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty