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General NPI Number Information
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NPI Number | 1134901952
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Entity Type | Organization
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Legal Business Name | LEXINGTON FAMILY SMILES
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Dates
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Enumeration Date | 10/17/2023
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 2001 AUGUSTA HWY STE B
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City | LEXINGTON
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State | SC
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Zip | 29072-1927
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Country | US
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Telephone | 803-951-0991
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Fax | 803-951-0995
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Provider Business Mailing Address
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Address Line | 1000 TOWNE CENTER BLVD STE 101
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City | POOLER
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State | GA
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Zip | 31322-4508
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Country | US
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Telephone | 912-748-8585
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW J ALLEN
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Credential | DDS
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Telephone | 803-951-0991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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