MEDICARE: SMILES BY DESIGN, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3909	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316092653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMILES BY DESIGN, PA

Provider Business Mailing Address
First Line	:	1096 ASSEMBLY DR
Second Line	:	SUITE 216
City	:	FORT MILL
State	:	SC
Zip	:	29708-6447
Country	:	US
Telephone Number	:	803-548-4899
Fax Number	:

Provider Business Practice Location Address
First Line	:	1096 ASSEMBLY DR
Second Line	:	SUITE 216
City	:	FORT MILL
State	:	SC
Zip	:	29708-6447
Country	:	US
Telephone Number	:	803-548-4899
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRIANNA SCHRAW
Credential	:	D.M.D
Telephone Number	:	803-548-4899

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	08/22/2020

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