Provider Demographics
NPI:1598512899
Name:SOUTHERN SMILES, PLLC
Entity type:Organization
Organization Name:SOUTHERN SMILES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:601-261-5541
Mailing Address - Street 1:114 N 40TH AVE
Mailing Address - Street 2:SUITE G #50
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-6663
Mailing Address - Country:US
Mailing Address - Phone:601-261-5541
Mailing Address - Fax:
Practice Address - Street 1:114 N 40TH AVE
Practice Address - Street 2:SUITE G #50
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-6663
Practice Address - Country:US
Practice Address - Phone:601-261-5541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental