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General NPI Number Information
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NPI Number | 1174081855
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Entity Type | Organization
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Legal Business Name | SMILE BEAUTIFUL, PLLC
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Dates
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Enumeration Date | 03/12/2019
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Last Update Date | 03/28/2021
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Provider Practice Location Address
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Address Line | 66 LEONARD ST STE 2
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City | BELMONT
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State | MA
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Zip | 02478-2512
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Country | US
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Telephone | 617-484-6558
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Fax |
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Provider Business Mailing Address
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Address Line | 42 CLARK ST
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City | BELMONT
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State | MA
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Zip | 02478-2452
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Country | US
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Telephone | 704-502-5897
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Fax |
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Authorized Official
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Title or Position | DDS
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Name | DR. KARESSA AMALIA KUNTZ
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Credential | DDS
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Telephone | 704-502-5897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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