Provider Demographics
NPI:1760110035
Name:DFW SMILES DENTIST TEAM PLLC
Entity Type:Organization
Organization Name:DFW SMILES DENTIST TEAM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DUNIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOROUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-693-6852
Mailing Address - Street 1:5649 LEBANON RD
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7263
Mailing Address - Country:US
Mailing Address - Phone:469-200-8123
Mailing Address - Fax:
Practice Address - Street 1:5649 LEBANON RD
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7263
Practice Address - Country:US
Practice Address - Phone:469-200-8123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty