Provider Demographics
NPI:1629503123
Name:KREATING PERFECT SMILES PLLC
Entity Type:Organization
Organization Name:KREATING PERFECT SMILES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSHABH
Authorized Official - Middle Name:
Authorized Official - Last Name:DOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-920-1917
Mailing Address - Street 1:1924 ANGEIN LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76131-1059
Mailing Address - Country:US
Mailing Address - Phone:201-920-2457
Mailing Address - Fax:
Practice Address - Street 1:2932 N BELT LINE RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-5247
Practice Address - Country:US
Practice Address - Phone:201-920-1917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-22
Last Update Date:2017-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32099122300000X
TX30885122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty