Provider Demographics
NPI:1932495678
Name:SMILEY DENTAL BISSONNET PLLC
Entity Type:Organization
Organization Name:SMILEY DENTAL BISSONNET PLLC
Other - Org Name:SMILEY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNHTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-466-1400
Mailing Address - Street 1:P.O. BOX 453247
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75218
Mailing Address - Country:US
Mailing Address - Phone:214-466-1400
Mailing Address - Fax:
Practice Address - Street 1:6047 BISSONNET ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-6903
Practice Address - Country:US
Practice Address - Phone:713-432-7222
Practice Address - Fax:713-432-7221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-21
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty