Organization
SMILE BRITE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFONSO CARLOS FERNANDEZ DDS (DENTIST)
(770) 474-7223
Entity
Organization
Contact information
Practice address
4084 N HENRY BLVD, STOCKBRIDGE, GA 30281
(770) 474-7223
(770) 474-4614
Mailing address
4084 N HENRY BLVD, STOCKBRIDGE, GA 30281
(770) 474-7223
(770) 474-4614
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11980
GA
122300000X
Dentist
14437
FL
Other
Enumeration date
09/07/2006
Last updated
03/27/2012
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