Provider Demographics
NPI:1205363082
Name:SMILE DOCS ORTHODONTICS, P.C.
Entity Type:Organization
Organization Name:SMILE DOCS ORTHODONTICS, P.C.
Other - Org Name:ELITE ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-408-4082
Mailing Address - Street 1:24526 KINGSLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3429
Mailing Address - Country:US
Mailing Address - Phone:281-408-4082
Mailing Address - Fax:972-559-1770
Practice Address - Street 1:24526 KINGSLAND BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3429
Practice Address - Country:US
Practice Address - Phone:281-408-4082
Practice Address - Fax:972-559-1770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX230061223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty