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Organization
ISMILE FAMILY DENTISTRY
Active
Organization
ISMILE FAMILY DENTISTRY
Active
Other names
iSmile Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LASHUNDA THOMPSON ROBERTS DMD (PRESIDENT)
(601) 622-1073
Entity
Organization
Contact information
Practice address
1305 CHURCH RD E, SOUTHAVEN, MS 38671-9711
(662) 349-1141
(662) 349-6227
Mailing address
PO BOX 1168, SOUTHAVEN, MS 38671-0012
(662) 349-1141
(662) 349-6227
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09709245
—
MS
Enumeration date
08/25/2021
Last updated
08/25/2021
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