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Organization
IDEAL SMILE DENTISTRY LLC
Active
Organization
IDEAL SMILE DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SETH WALDEN (CEO)
(678) 910-1716
Entity
Organization
Contact information
Practice address
2979 N LAKE PKWY STE 100, COLUMBUS, GA 31909-2575
(678) 910-1716
Mailing address
3915 PIEDMONT LAKE RD, PINE MOUNTAIN, GA 31822-3558
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/22/2023
Last updated
05/30/2023
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