Organization
30A SMILES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM FLEITZ (CSO)
(850) 231-0070
Entity
Organization
Contact information
Practice address
12805 US HIGHWAY 98 E, SUITE K 201, INLET BEACH, FL 32413-9630
(850) 231-0070
Mailing address
12805 US HIGHWAY 98 E, SUITE K 201, INLET BEACH, FL 32413-9630
(850) 231-0070
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN15148
FL
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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