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General NPI Number Information
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NPI Number | 1275359655
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Entity Type | Organization
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Legal Business Name | SIMPLY SMILE P.S.C.
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 3920 POINTER RD
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City | LOGANVILLE
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State | GA
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Zip | 30052-2889
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Country | US
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Telephone | 404-313-0944
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Fax |
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Provider Business Mailing Address
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Address Line | 3920 POINTER RD
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City | LOGANVILLE
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State | GA
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Zip | 30052-2889
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Country | US
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Telephone | 404-313-0944
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Fax |
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Authorized Official
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Title or Position | DENTAL HYGIENIST
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Name | MRS. ROCKY MOUA COATES
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Credential | RDH
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Telephone | 404-313-0944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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