# FOREVER SMILES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083988596
- **Authorized official:** JEFFERY DYE (PRESIDENT)
- **Authorized official phone:** (606) 949-6971

## Contact information

- **Practice address:** 6363 KENTUCKY ROUTE 1428, ALLEN, KY 41601
- **Practice address phone:** (606) 949-6971
- **Practice address fax:** (606) 949-6986
- **Mailing address:** PO BOX 308, 6363 KENTUCKY ROUTE 1428, ALLEN, KY 41601
- **Mailing address phone:** (606) 949-6971
- **Mailing address fax:** (606) 949-6986

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6977 | KY | Yes |
| 1223G0001X | General Practice Dentistry | 7084 | KY | — |

## Other

- **Enumeration date:** 03/01/2012
- **Last updated:** 07/18/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 60069770 | — | KY |