Organization
ISMILE FAMILY DENTISTRY
Active
Other names
iSmile Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LASHUNDA THOMPSON ROBERTS DMD (PRESIDENT)
(601) 622-1073
Entity
Organization
Contact information
Practice address
1305 CHURCH RD E, SOUTHAVEN, MS 38671-9711
(662) 349-1141
(662) 349-6227
Mailing address
PO BOX 1168, SOUTHAVEN, MS 38671-0012
(662) 349-1141
(662) 349-6227
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09709245
—
MS
Enumeration date
08/25/2021
Last updated
08/25/2021
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