Organization
SUPER SMILES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANCIS P SHAEFFER D.M.D (DOCTOR)
(404) 636-1200
Entity
Organization
Contact information
Practice address
2058 N DECATUR RD, DECATUR, GA 30033-5306
(404) 636-1200
(404) 636-1199
Mailing address
2058 N DECATUR RD, DECATUR, GA 30033-5306
(404) 636-1200
(404) 636-1199
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
012746
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
425180080B
MEDICAID
GA
Enumeration date
05/20/2008
Last updated
05/20/2008
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