Provider Demographics
NPI:1013218155
Name:A PERFECT SMILE ORTHODONTICS
Entity Type:Organization
Organization Name:A PERFECT SMILE ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-630-6166
Mailing Address - Street 1:3301 N K CTR
Mailing Address - Street 2:#C101
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-1528
Mailing Address - Country:US
Mailing Address - Phone:956-630-6166
Mailing Address - Fax:
Practice Address - Street 1:1400 E EXPRESSWAY 83
Practice Address - Street 2:STE 155
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1662
Practice Address - Country:US
Practice Address - Phone:956-630-6166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX237671223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty