Healthcare Provider Details

I. General information

NPI: 1669398939
Provider Name (Legal Business Name): THE SMILE MISSION FORT PIERCE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 S US HIGHWAY 1
FORT PIERCE FL
34982-6364
US

IV. Provider business mailing address

9900 SW 168TH ST STE 1
MIAMI FL
33157-4378
US

V. Phone/Fax

Practice location:
  • Phone: 786-701-8246
  • Fax:
Mailing address:
  • Phone: 786-701-8246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DUSTIN PFUNDHELLER
Title or Position: OWNER
Credential:
Phone: 786-701-8246