Provider Demographics
NPI:1750774709
Name:SMILES AT TELFAIR FAMILY AND COSMETIC DENTISTRY
Entity type:Organization
Organization Name:SMILES AT TELFAIR FAMILY AND COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:INSIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-356-0786
Mailing Address - Street 1:1227 MUSEUM SQUARE DR STE D
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3692
Mailing Address - Country:US
Mailing Address - Phone:832-356-0786
Mailing Address - Fax:
Practice Address - Street 1:1227 MUSEUM SQUARE DR STE D
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3692
Practice Address - Country:US
Practice Address - Phone:832-356-0786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty