Provider Demographics
NPI:1760762009
Name:HAPPY TEETH DENTAL CENTERS OF MESQUITE PC
Entity Type:Organization
Organization Name:HAPPY TEETH DENTAL CENTERS OF MESQUITE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLAYEM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-285-2600
Mailing Address - Street 1:2020 N MASTERS DR
Mailing Address - Street 2:# 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75217-3168
Mailing Address - Country:US
Mailing Address - Phone:972-285-2600
Mailing Address - Fax:972-285-2605
Practice Address - Street 1:525 N GALLOWAY AVE
Practice Address - Street 2:SUITE 507
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149
Practice Address - Country:US
Practice Address - Phone:972-285-2600
Practice Address - Fax:972-285-2605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty