Provider Demographics
NPI:1003218827
Name:ASHLEY SMILES DENTAL ASSOCIATION
Entity Type:Organization
Organization Name:ASHLEY SMILES DENTAL ASSOCIATION
Other - Org Name:ASHLEY SMILE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WINIFRED
Authorized Official - Middle Name:OGE
Authorized Official - Last Name:DIKE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-777-3368
Mailing Address - Street 1:3711 HIGHWAY 6 S
Mailing Address - Street 2:SUITE 200-A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-4322
Mailing Address - Country:US
Mailing Address - Phone:713-777-3368
Mailing Address - Fax:713-777-3370
Practice Address - Street 1:3711 HIGHWAY 6 S
Practice Address - Street 2:SUITE 200-A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-4322
Practice Address - Country:US
Practice Address - Phone:713-777-3368
Practice Address - Fax:713-777-3370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21637122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty