Healthcare Provider Details

I. General information

NPI: 1568386456
Provider Name (Legal Business Name): G SMILES DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 COUNTRY CLUB PKWY SUITES D & E
MAUMELLE AR
72113
US

IV. Provider business mailing address

88 LUCIA LN
MAUMELLE AR
72113-7627
US

V. Phone/Fax

Practice location:
  • Phone: 501-992-9990
  • Fax: 501-992-9991
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RONTAE GRAHAM
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 501-538-4630