Provider Demographics
NPI:1831647064
Name:FAMILY SMILES DENTAL OF CONROE PC
Entity Type:Organization
Organization Name:FAMILY SMILES DENTAL OF CONROE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAHUDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-260-4075
Mailing Address - Street 1:100 MEDICAL CENTER BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2821
Mailing Address - Country:US
Mailing Address - Phone:936-441-0033
Mailing Address - Fax:832-442-3424
Practice Address - Street 1:100 MEDICAL CENTER BLVD STE 109
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2821
Practice Address - Country:US
Practice Address - Phone:936-441-0033
Practice Address - Fax:832-442-3424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX244341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty