Provider Demographics
NPI:1740641976
Name:SIGNATURE SMILES WOODLANDS, PLLC
Entity type:Organization
Organization Name:SIGNATURE SMILES WOODLANDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:STANWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-334-2476
Mailing Address - Street 1:2400 FM 1488 RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4958
Mailing Address - Country:US
Mailing Address - Phone:936-224-7007
Mailing Address - Fax:
Practice Address - Street 1:2400 FM 1488 SUITE 200
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384
Practice Address - Country:US
Practice Address - Phone:713-701-9845
Practice Address - Fax:713-673-8039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-16
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty