Organization
SMILES FOR KIDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JYOTI DESH SHARMA DMD (OWNER)
(404) 433-1317
Entity
Organization
Contact information
Practice address
1240 BUFORD RD, SUITE 150, CUMMING, GA 30041-2731
(770) 781-0203
(770) 781-0204
Mailing address
5140 BEECHAM CT, SUWANEE, GA 30024-3390
(404) 433-1317
(770) 781-0204
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN12806
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
437813642M
—
GA
Enumeration date
02/03/2012
Last updated
02/03/2012
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