Provider Demographics
NPI:1811369796
Name:ANGELIE ZAMORA DDS PC
Entity Type:Organization
Organization Name:ANGELIE ZAMORA DDS PC
Other - Org Name:SMILES OF LAS COLINAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELIE
Authorized Official - Middle Name:V
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-444-9337
Mailing Address - Street 1:7429 LAS COLINAS BLVD
Mailing Address - Street 2:# D100
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-7571
Mailing Address - Country:US
Mailing Address - Phone:972-444-9337
Mailing Address - Fax:972-444-9557
Practice Address - Street 1:7429 LAS COLINAS BLVD
Practice Address - Street 2:# D100
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-7571
Practice Address - Country:US
Practice Address - Phone:972-444-9337
Practice Address - Fax:972-444-9557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-30
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
TX18945332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment