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Organization
LAKE MARY SMILES, PLLC
Active
Organization
LAKE MARY SMILES, PLLC
Active
Other names
Lake Mary Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
PETER KELLY (OWNER)
(407) 333-7393
Entity
Organization
Contact information
Practice address
1511 INTERNATIONAL PKWY, LAKE MARY, FL 32746-4708
(407) 333-7393
Mailing address
3221 CONWAY RD STE D, ORLANDO, FL 32812-7354
(407) 432-6224
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DM19430
STATE LICENSE
FL
Enumeration date
03/24/2022
Last updated
06/03/2026
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