Healthcare Provider Details

I. General information

NPI: 1235047606
Provider Name (Legal Business Name): ALL SMILES FAMILY DENTISTRY,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 MULKEY RD STE 4
AUSTELL GA
30106-1122
US

IV. Provider business mailing address

1790 MULKEY RD STE 4
AUSTELL GA
30106-1122
US

V. Phone/Fax

Practice location:
  • Phone: 770-739-4400
  • Fax: 770-739-9077
Mailing address:
  • Phone: 770-739-4400
  • Fax: 770-739-9077

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. ARLITA DEVON JACKSON
Title or Position: OWNER/PROVIDER
Credential: DMD
Phone: 770-739-4400