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General NPI Number Information
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NPI Number | 1811034671
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Entity Type | Organization
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Legal Business Name | BE ORTHODONTICS, INC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 03/03/2008
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Provider Practice Location Address
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Address Line | 3614 HIGHLANDS PKWY SE
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City | SMYRNA
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State | GA
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Zip | 30082-5184
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Country | US
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Telephone | 770-432-6070
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Fax | 770-432-5122
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Provider Business Mailing Address
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Address Line | 3614 HIGHLANDS PKWY SE
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City | SMYRNA
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State | GA
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Zip | 30082-5184
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Country | US
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Telephone | 770-432-6070
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Fax | 770-432-5122
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. PORTIA ELLIS CARTER
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Credential | DDS
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Telephone | 770-432-6070
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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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