Provider Demographics
NPI:1639839509
Name:WEST POINT SMILES PC
Entity type:Organization
Organization Name:WEST POINT SMILES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROZELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-645-2254
Mailing Address - Street 1:1107 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:31833-1217
Mailing Address - Country:US
Mailing Address - Phone:706-645-2254
Mailing Address - Fax:
Practice Address - Street 1:1107 3RD AVE
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:GA
Practice Address - Zip Code:31833-1217
Practice Address - Country:US
Practice Address - Phone:706-645-2254
Practice Address - Fax:706-643-5894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-20
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty