Organization
SMILE DESIGNERS LLC
Active
Parent organization
SMILE DESIGNERS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SMILE DESIGNERS LLC
Authorized official
DR. KEISHA DENYEL QUINN D.D.S. (PRESUDENT)
(601) 649-4854
Entity
Organization
Contact information
Practice address
1709 W 20TH ST, LAUREL, MS 39440-1802
(601) 649-4854
(601) 651-6439
Mailing address
1709 W 20TH ST, LAUREL, MS 39440-1802
(601) 649-4854
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
256990
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00060078
—
MS
05
—
02303099
—
MS
Enumeration date
05/29/2013
Last updated
05/29/2013
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