Organization
SMILE REVOLUTION PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PETERSON (FINANCIAL MANAGER)
(423) 472-6482
Entity
Organization
Contact information
Practice address
2217 OLAN MILLS DR, CHATTANOOGA, TN 37421-1891
(423) 599-8363
Mailing address
148 STUART XING NE, CLEVELAND, TN 37312-4065
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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