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General NPI Number Information
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NPI Number | 1932752565
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Entity Type | Organization
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Legal Business Name | HAPPY TEETH PC
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Dates
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Enumeration Date | 07/23/2019
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 3931 HIGHWAY 78 W STE A
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City | SNELLVILLE
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State | GA
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Zip | 30039-3907
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Country | US
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Telephone | 770-985-1050
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Fax | 800-985-8967
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Provider Business Mailing Address
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Address Line | 3931 HIGHWAY 78 W STE A
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City | SNELLVILLE
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State | GA
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Zip | 30039-3907
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Country | US
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Telephone | 770-985-1050
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Fax | 800-985-8967
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARIA C PULLIAM
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Credential | RDH
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Telephone | 770-469-1331
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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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