Provider Demographics
NPI:1710309299
Name:SMILE 4 TEXAS DENTAL CENTER LLP
Entity Type:Organization
Organization Name:SMILE 4 TEXAS DENTAL CENTER LLP
Other - Org Name:SMILE 4 TEXAS DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DUC-HUY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-283-2437
Mailing Address - Street 1:6803 TURTLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-2751
Mailing Address - Country:US
Mailing Address - Phone:832-283-2437
Mailing Address - Fax:
Practice Address - Street 1:1400 BLALOCK RD
Practice Address - Street 2:SUITE D-1
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-4483
Practice Address - Country:US
Practice Address - Phone:832-283-2437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29121122300000X
TX29110122300000X
TX29113122300000X
TX29093122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty