MEDICARE: HEALTHY SMILES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	4894	AL

General Provider Information

NPI Number	:	1265595052
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHY SMILES PC

Provider Business Mailing Address
First Line	:	4815 SPARKMAN DR NW
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35810-3948
Country	:	US
Telephone Number	:	256-858-6055
Fax Number	:	256-858-6161

Provider Business Practice Location Address
First Line	:	4815 SPARKMAN DR NW
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35810-3948
Country	:	US
Telephone Number	:	256-858-6055
Fax Number	:	256-858-6161

Authorized Official
Title or Position	:	DOCTOR OWNER
Name	:	DR. ANGELA WRIGHT BROWN
Credential	:	DDS
Telephone Number	:	256-858-6055

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	07/25/2008

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Directions to “HEALTHY SMILES PC ” Practice Location

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