Organization
AMAZING SMILES STUDIO ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEISHA N ALEXANDER D.D.S., M.S. (PRESIDENT)
(919) 360-0607
Entity
Organization
Contact information
Practice address
4000 VICTORIA PARK DR APT 4101, DAVENPORT, FL 33896-3200
(919) 360-0607
Mailing address
4000 VICTORIA PARK DR APT 4101, DAVENPORT, FL 33896-3200
(919) 360-0607
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN18362
FL
Other
Enumeration date
07/20/2011
Last updated
01/04/2013
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