Provider Demographics
NPI:1760751374
Name:KEEP SMILIN FAMILY DENTAL PLLC
Entity Type:Organization
Organization Name:KEEP SMILIN FAMILY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:915-855-3220
Mailing Address - Street 1:2281 ZARAGOZA RD
Mailing Address - Street 2:102 103
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-7987
Mailing Address - Country:US
Mailing Address - Phone:915-855-3220
Mailing Address - Fax:915-855-3404
Practice Address - Street 1:2281 N.ZARAGOZA RD.
Practice Address - Street 2:SUITE 102 & 103
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938
Practice Address - Country:US
Practice Address - Phone:915-855-3220
Practice Address - Fax:915-855-3404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-28
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21507261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX21507OtherTEXAS DENTAL LICENSE