Provider Demographics
NPI:1417253105
Name:PLANET SMILE DENTAL CENTERS, PLLC
Entity Type:Organization
Organization Name:PLANET SMILE DENTAL CENTERS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-809-4228
Mailing Address - Street 1:15424 FM 1825
Mailing Address - Street 2:BUILDING 1, SUITE 120
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3142
Mailing Address - Country:US
Mailing Address - Phone:512-308-0270
Mailing Address - Fax:
Practice Address - Street 1:15424 FM 1825
Practice Address - Street 2:BUILDING 1, SUITE 120
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3142
Practice Address - Country:US
Practice Address - Phone:512-308-0270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX221321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty