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Contact Information

SOUTHEAST MOBILE SMILES
842 BROOKSHIRE BLVD
MARYVILLE, TN37803-6475
 Phone: 865-441-2527
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dental Public Health

1223D0001X
Indicates primary specialty

NPI Profile & details for SOUTHEAST MOBILE SMILES

NPI # 1427569664
LBN Legal business name SOUTHEAST MOBILE SMILES
Authorized official CALLIE FISHEL - (DENTAL HYGIENIST)
Entity Organization
Organization subpart 1 No
Enumeration date 10/16/2017
Last updated 10/16/2017 - About 9 years ago
Identifiers
TN License # DS9854
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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