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General NPI Number Information
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NPI Number | 1568386456
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Entity Type | Organization
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Legal Business Name | G SMILES DENTISTRY PLLC
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 1020 COUNTRY CLUB PKWY SUITES D & E
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City | MAUMELLE
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State | AR
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Zip | 72113
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Country | US
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Telephone | 501-538-4630
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Fax |
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Provider Business Mailing Address
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Address Line | 88 LUCIA LN
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City | MAUMELLE
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State | AR
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Zip | 72113-7627
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. RONTAE GRAHAM
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Credential | DDS
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Telephone | 501-538-4630
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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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