Provider Demographics
NPI:1922234541
Name:LITTLE SMILES OF SIENNA
Entity Type:Organization
Organization Name:LITTLE SMILES OF SIENNA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TEPPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:THACH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:281-778-0013
Mailing Address - Street 1:9201 SIENNA RANCH RD.
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459
Mailing Address - Country:US
Mailing Address - Phone:281-778-0013
Mailing Address - Fax:281-778-8080
Practice Address - Street 1:9201 SIENNA RANCH RD.
Practice Address - Street 2:SUITE 103
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459
Practice Address - Country:US
Practice Address - Phone:281-778-0013
Practice Address - Fax:281-778-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX230741223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty