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General NPI Number Information
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NPI Number | 1013211309
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Entity Type | Organization
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Legal Business Name | HEALTHYSMILES4HAPPY KIDS
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Dates
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Enumeration Date | 12/31/2010
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Last Update Date | 12/31/2010
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Provider Practice Location Address
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Address Line | 1248 STONE HARBOUR RD
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-4739
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Country | US
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Telephone | 407-803-2904
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Fax | 407-542-4634
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Provider Business Mailing Address
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Address Line | 1248 STONE HARBOUR RD
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-4739
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Country | US
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Telephone | 407-803-2904
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Fax | 407-542-4634
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. RHONDA LYNN MILLER
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Credential |
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Telephone | 407-803-2904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12608
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH8826
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License Number State | FL
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