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Organization
ULTIMATE SMILE DESIGN LLC
Active
Organization
ULTIMATE SMILE DESIGN LLC
Active
Parent organization
ULTIMATE SMILE DESIGN
Organization subpart
Yes
Provider details
NPI number
Legal business name
ULTIMATE SMILE DESIGN
Authorized official
MICHELE MILLER (OFFICE MANAGER)
(321) 984-7878
Entity
Organization
Contact information
Practice address
730 EMERSON DR NE, PALM BAY, FL 32907-1430
(321) 984-7878
Mailing address
730 EMERSON DR NE, PALM BAY, FL 32907-1430
(321) 984-7878
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN10353
FL
1223G0001X
General Practice Dentistry
DN20799
FL
Other
Enumeration date
11/29/2016
Last updated
11/29/2016
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