Organization
MS ODP OXFORD ORTHODONTICS PLLC
Active
Organization
MS ODP OXFORD ORTHODONTICS PLLC
Active
Other names
Rebel Smiles Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN SMITH (VP)
(470) 207-3264
Entity
Organization
Contact information
Practice address
2311 JACKSON AVE W STE 302, OXFORD, MS 38655-5751
(662) 612-0063
Mailing address
2300 LAKEVIEW PARKWAY STE. 250, ALPHARETTA, GA 30009-3954
(470) 207-3264
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
08/22/2024
Last updated
05/20/2026
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