Provider Demographics
NPI:1033528955
Name:SMILINE DENTAL TEXAS PLLC
Entity Type:Organization
Organization Name:SMILINE DENTAL TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAKRAPANI
Authorized Official - Middle Name:
Authorized Official - Last Name:NANNAPANENI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-276-4888
Mailing Address - Street 1:1605 N GARLAND AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-9417
Mailing Address - Country:US
Mailing Address - Phone:972-276-4888
Mailing Address - Fax:972-276-7888
Practice Address - Street 1:1605 N GARLAND AVE
Practice Address - Street 2:SUITE C
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-9417
Practice Address - Country:US
Practice Address - Phone:972-276-4888
Practice Address - Fax:972-276-7888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX292731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty