Organization
THE SMILE STUDIO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM O RIVES DMD (OWNER)
(601) 605-2525
Entity
Organization
Contact information
Practice address
1029 HIGHWAY 51 STE D, MADISON, MS 39110-7648
(601) 605-2525
(601) 605-2524
Mailing address
1029 HIGHWAY 51 STE D, MADISON, MS 39110-7648
(601) 605-2525
(601) 605-2524
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
320701
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06684372
—
MS
Enumeration date
05/30/2008
Last updated
05/30/2008
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