| Organization Name: | SMILE FACTORY WELLNESS DENTAL CLINIC INC |
| NPI Number: | 1396063434 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ADA L FRAZIER (OWNER) |
| Mailing Address: | 11808 Hwy 231 431 N Meridianville |
| State: | AL US |
| Postal Code: | 357592126 |
| Phone Number: | 2568281500 |
| Fax Number: | 2568281515 |
| NPI Enumeration Date: | 05/13/2010 |
| NPI Last Update Date: | 05/13/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | DS4310 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |