Organization
MODERN SMILES DENTISTRY, P.C.
Active
Parent organization
MODERN SMILES DENTISTRY, P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MODERN SMILES DENTISTRY, P.C.
Authorized official
OLUYEMI WORKMAN DDS (DENTIST)
(770) 800-1044
Entity
Organization
Contact information
Practice address
2095 HIGHWAY 211 NW STE 6A, BRASELTON, GA 30517-3403
(770) 800-1044
Mailing address
2095 HIGHWAY 211 NW STE 6A, BRASELTON, GA 30517-3403
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
09/26/2018
Last updated
06/26/2020
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