Provider Demographics
NPI:1821222407
Name:MARKETPLACE SMILES, P.A.
Entity Type:Organization
Organization Name:MARKETPLACE SMILES, P.A.
Other - Org Name:MARKETPLACE SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-868-5000
Mailing Address - Street 1:400 DEL WEBB BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-4354
Mailing Address - Country:US
Mailing Address - Phone:512-868-5000
Mailing Address - Fax:512-868-5001
Practice Address - Street 1:400 DEL WEBB BLVD STE 104
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78633-4354
Practice Address - Country:US
Practice Address - Phone:512-868-5000
Practice Address - Fax:512-868-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX231301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty