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General NPI Number Information
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NPI Number | 1346487105
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Entity Type | Organization
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Legal Business Name | SMILES AHEAD, P.C.
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Dates
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Enumeration Date | 01/15/2009
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Last Update Date | 12/20/2011
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Provider Practice Location Address
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Address Line | 7127 U S HIGHWAY 98 SUITE 10
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City | HATTIESBURG
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State | MS
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Zip | 39402-8452
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Country | US
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Telephone | 601-450-4320
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Fax | 601-450-4323
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Provider Business Mailing Address
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Address Line | 7127 U S HIGHWAY 98 SUITE 10
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City | HATTIESBURG
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State | MS
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Zip | 39402-8452
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Country | US
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Telephone | 601-450-4320
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Fax | 601-450-4323
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | DR. CHRISTY DRYDEN HEAD
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Credential | D.D.S.
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Telephone | 601-450-4320
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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 | 3423
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License Number State | MS
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