Provider Demographics
NPI:1447549191
Name:HEALTHY SMILES DENTAL CARE OF FLINT, PLLC
Entity type:Organization
Organization Name:HEALTHY SMILES DENTAL CARE OF FLINT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-751-5106
Mailing Address - Street 1:PO BOX 340
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-0340
Mailing Address - Country:US
Mailing Address - Phone:734-253-6150
Mailing Address - Fax:734-627-9180
Practice Address - Street 1:4170 LENNON RD STE A
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1083
Practice Address - Country:US
Practice Address - Phone:810-720-6433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-04
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0157031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty