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General NPI Number Information
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NPI Number | 1528853751
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Entity Type | Organization
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Legal Business Name | THE SMILE SOCIETY, PLLC
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 7540 GATE PKWY # 110
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City | JACKSONVILLE
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State | FL
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Zip | 32256-2887
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Country | US
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Telephone | 904-323-3140
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Fax |
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Provider Business Mailing Address
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Address Line | 7540 GATE PKWY STE 110
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City | JACKSONVILLE
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State | FL
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Zip | 32256-3104
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Country | US
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Telephone | 904-323-3140
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. KENJULA BROWN
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Credential | DDS
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Telephone | 904-323-3240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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