Organization
SIMPLE SMILES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEN CUTLER (SECRETARY)
(607) 743-9474
Entity
Organization
Contact information
Practice address
712 W WALNUT ST, JOHNSON CITY, TN 37604-6524
(423) 218-0968
Mailing address
296 S MAIN ST STE 300, ALPHARETTA, GA 30009-1973
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
02/10/2022
Last updated
02/10/2022
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