| Smiles On Main | |
|
342 N Main St Suite 110 Alpharetta GA 30004-8376 | |
| (678) 762-1613 | |
| (678) 762-1689 |
| Full Name | Smiles On Main |
|---|---|
| Speciality | Dentist |
| Location | 342 N Main St, Alpharetta, Georgia |
| Authorized Official Name and Position | Ketankumar G Patel (DENTIST) |
| Authorized Official Contact | 6787621613 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smiles On Main 342 N Main St Suite 110 Alpharetta GA 30004-8376 Ph: (678) 762-1613 | Smiles On Main 342 N Main St Suite 110 Alpharetta GA 30004-8376 Ph: (678) 762-1613 |
| NPI Number | 1740308576 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 11/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740308576 | NPI | - | NPPES |
| 500129458B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN012835 (Georgia) | Primary |
| 122300000X | Dentist | DN008017 (Georgia) | Secondary |
| 122300000X | Dentist | DN007359 (Georgia) | Secondary |
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