Beautiful Smiles of Fayetteville

NPI #1972973766 in Fayetteville, Georgia

Provider Information

NPI Number: 1972973766
Entity Type: Organization
Organization Name: Beautiful Smiles of Fayetteville
Primary Specialty: Dentist
Enumeration Date: Oct 6, 2015
Last Updated: Oct 6, 2015

Practice Location

Address: 719 LANIER AVE W STE A1
City: Fayetteville
State: Georgia
ZIP Code: 30214-7634
Phone: (404) 696-6595

Authorized Official

Name: DR. PAUL MCKOY, DDS
Title: CFO
Phone: (404) 696-6595

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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