Provider Demographics
NPI:1508168204
Name:DESIGNER SMILES
Entity Type:Organization
Organization Name:DESIGNER SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGGARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-338-9032
Mailing Address - Street 1:1015 MEDICAL CENTER BLVD
Mailing Address - Street 2:STE 1600
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4052
Mailing Address - Country:US
Mailing Address - Phone:281-338-9032
Mailing Address - Fax:281-338-9039
Practice Address - Street 1:1015 MEDICAL CENTER BLVD
Practice Address - Street 2:STE 1600
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4052
Practice Address - Country:US
Practice Address - Phone:281-338-9032
Practice Address - Fax:281-338-9039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty