# HEALTHY SMILES FAMILY & COSMETIC DENTISTRY PSC

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

## Provider details

- **NPI number:** 1194064493
- **Authorized official:** DR. MISTY DAWN CLARK DMD (DENTIST)
- **Authorized official phone:** (606) 886-0300

## Contact information

- **Practice address:** 83 OAK RIDGE CT, PRESTONSBURG, KY 41653-8595
- **Practice address phone:** (606) 886-0300
- **Practice address fax:** (606) 886-9334
- **Mailing address:** 83 OAK RIDGE CT, PRESTONSBURG, KY 41653-8595
- **Mailing address phone:** (606) 886-0300
- **Mailing address fax:** (606) 886-9334

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 8481 | KY | Yes |

## Other

- **Enumeration date:** 02/06/2013
- **Last updated:** 02/06/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100088720 | — | KY |