Provider Demographics
NPI:1740435064
Name:SMILEY DENTAL-RIVER OAKS PLLC
Entity type:Organization
Organization Name:SMILEY DENTAL-RIVER OAKS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYNH
Authorized Official - Middle Name:THY
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-718-7880
Mailing Address - Street 1:10901 GARLAND RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-2613
Mailing Address - Country:US
Mailing Address - Phone:214-718-7880
Mailing Address - Fax:
Practice Address - Street 1:4843 RIVER OAKS BLVD
Practice Address - Street 2:
Practice Address - City:RIVER OAKS
Practice Address - State:TX
Practice Address - Zip Code:76114
Practice Address - Country:US
Practice Address - Phone:214-718-7880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty