Provider Demographics
NPI:1770120008
Name:SMILE BRIGHT DENTAL STUDIO
Entity type:Organization
Organization Name:SMILE BRIGHT DENTAL STUDIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NKECHI
Authorized Official - Middle Name:
Authorized Official - Last Name:NWAGWU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-852-9883
Mailing Address - Street 1:6300 FM 1463 RD STE 150
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1849
Mailing Address - Country:US
Mailing Address - Phone:281-852-9883
Mailing Address - Fax:
Practice Address - Street 1:6300 FM 1463
Practice Address - Street 2:150
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-7740
Practice Address - Country:US
Practice Address - Phone:281-989-0087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental