# GENESIS SMILES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Genesis Smiles Pediatric Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154012722
- **Authorized official:** DR. BHAVNA T PAHEL DDS, PHD (MANAGING MEMBER)
- **Authorized official phone:** (864) 715-3200

## Contact information

- **Practice address:** 810 E MAIN ST STE G, LAURENS, SC 29360-3547
- **Practice address phone:** (864) 715-3200
- **Mailing address:** 10 BELGIAN BLUE WAY, FOUNTAIN INN, SC 29644-7912
- **Mailing address phone:** (864) 715-3200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/16/2023
- **Last updated:** 07/01/2023