Provider Demographics
NPI:1063194454
Name:SOMERSMILES LLC
Entity type:Organization
Organization Name:SOMERSMILES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHINMAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MISHRA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:651-373-5547
Mailing Address - Street 1:5030 VILLAGE GREEN WAY
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-3646
Mailing Address - Country:US
Mailing Address - Phone:651-373-5547
Mailing Address - Fax:
Practice Address - Street 1:6234 OLD HIGHWAY 5 STE B1B2
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-7806
Practice Address - Country:US
Practice Address - Phone:470-758-2166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental