Provider Demographics
NPI:1376176172
Name:COTULLA SMILES PLLC
Entity Type:Organization
Organization Name:COTULLA SMILES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVEK
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:830-483-1590
Mailing Address - Street 1:649 LAS PALMAS BLVD STE 8/9
Mailing Address - Street 2:
Mailing Address - City:COTULLA
Mailing Address - State:TX
Mailing Address - Zip Code:78014-3209
Mailing Address - Country:US
Mailing Address - Phone:830-483-1590
Mailing Address - Fax:
Practice Address - Street 1:649 LAS PALMAS BLVD STE 8/9
Practice Address - Street 2:
Practice Address - City:COTULLA
Practice Address - State:TX
Practice Address - Zip Code:78014-3209
Practice Address - Country:US
Practice Address - Phone:830-483-1590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental