Provider Demographics
NPI:1255851770
Name:ZEE SMILE DENTAL INC
Entity type:Organization
Organization Name:ZEE SMILE DENTAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ESEOGHENE
Authorized Official - Middle Name:ERHUVWUYOMA
Authorized Official - Last Name:OKUGBAYE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:678-698-1440
Mailing Address - Street 1:1209 GENESIS DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8651
Mailing Address - Country:US
Mailing Address - Phone:678-698-1440
Mailing Address - Fax:817-783-6705
Practice Address - Street 1:5189 E INTERSTATE 20 SERVICE RD S
Practice Address - Street 2:102
Practice Address - City:WILLOW PARK
Practice Address - State:TX
Practice Address - Zip Code:76087
Practice Address - Country:US
Practice Address - Phone:817-441-2684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-26
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26223261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental