Provider Demographics
NPI:1740558691
Name:ABOUT SMILES FAMILY DENTAL
Entity Type:Organization
Organization Name:ABOUT SMILES FAMILY DENTAL
Other - Org Name:GRETCHEN S HOOVER, DDS, PC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOOVER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-444-5577
Mailing Address - Street 1:2555 WESTERN TRAILS BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1687
Mailing Address - Country:US
Mailing Address - Phone:512-444-5577
Mailing Address - Fax:512-892-6270
Practice Address - Street 1:2555 WESTERN TRAILS BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1687
Practice Address - Country:US
Practice Address - Phone:512-444-5577
Practice Address - Fax:512-892-6270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX223071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty