Provider Demographics
NPI:1255804670
Name:ROSENBERG FAMILY SMILES PLLC
Entity type:Organization
Organization Name:ROSENBERG FAMILY SMILES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDRANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-232-6610
Mailing Address - Street 1:4114 AVENUE H
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2833
Mailing Address - Country:US
Mailing Address - Phone:281-232-6610
Mailing Address - Fax:281-232-8289
Practice Address - Street 1:4114 AVENUE H
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2833
Practice Address - Country:US
Practice Address - Phone:281-232-6610
Practice Address - Fax:281-232-8289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty