Provider Demographics
NPI:1740585173
Name:SMILE ARTIST DENTISTRY PLLC
Entity Type:Organization
Organization Name:SMILE ARTIST DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RODRIGO
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-899-1789
Mailing Address - Street 1:11014 LINDEN GATE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-2440
Mailing Address - Country:US
Mailing Address - Phone:832-308-1921
Mailing Address - Fax:
Practice Address - Street 1:10065 ALMEDA GENOA RD STE J
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-2417
Practice Address - Country:US
Practice Address - Phone:832-308-1921
Practice Address - Fax:832-308-1925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-15
Last Update Date:2011-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX238621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty