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Organization

SMILE MISSION FAYETTEVILLE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DUSTIN PFUNDHELLER (MANAGER)
(786) 701-8246
Entity
Organization

Contact information

Practice address
655 N JEFF DAVIS DR, FAYETTEVILLE, GA 30214-1649
(786) 701-8246
Mailing address
9900 SW 168TH ST STE 1, MIAMI, FL 33157-4378
(786) 701-8246

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
05/31/2025
Last updated
05/31/2025
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