| Sparkling Smiles Fayetteville Llc | |
|
1233 Highway 54 W Ste 100 Fayetteville GA 30214-4542 | |
| (770) 461-6465 | |
| Not Available |
| Full Name | Sparkling Smiles Fayetteville Llc |
|---|---|
| Speciality | Dentist |
| Location | 1233 Highway 54 W Ste 100, Fayetteville, Georgia |
| Authorized Official Name and Position | Michael Cole (VP INSURANCE PLAN MANAGEMENT) |
| Authorized Official Contact | 7274242990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sparkling Smiles Fayetteville Llc 1233 Highway 54 W Ste 100 Fayetteville GA 30214-4542 Ph: (770) 461-6465 | Sparkling Smiles Fayetteville Llc 1233 Highway 54 W Ste 100 Fayetteville GA 30214-4542 Ph: (770) 461-6465 |
| NPI Number | 1508549932 |
|---|---|
| Provider Enumeration Date | 08/11/2023 |
| Last Update Date | 08/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508549932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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