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General NPI Number Information
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NPI Number | 1275315269
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Entity Type | Organization
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Legal Business Name | CLINICA SONRISAS LLC
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Dates
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Enumeration Date | 10/16/2023
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 1148 E 23RD ST
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City | CHATTANOOGA
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State | TN
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Zip | 37408-2213
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Country | US
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Telephone | 423-760-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 4803 HIXSON PIKE STE 101
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City | HIXSON
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State | TN
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Zip | 37343-4486
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Country | US
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Telephone | 423-842-0165
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Fax |
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Authorized Official
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Title or Position | DENTAL PARTNER
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Name | DR. BETH WEBB
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Credential | DDS
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Telephone | 423-842-0165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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