Provider Demographics
NPI:1831741693
Name:SMILEY DENTAL TEXARKANA
Entity type:Organization
Organization Name:SMILEY DENTAL TEXARKANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUNG JOON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-466-1400
Mailing Address - Street 1:PO BOX 453247
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75045-3247
Mailing Address - Country:US
Mailing Address - Phone:214-466-1400
Mailing Address - Fax:214-367-5896
Practice Address - Street 1:3225 KENNEDY LN
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2428
Practice Address - Country:US
Practice Address - Phone:214-466-1400
Practice Address - Fax:214-466-1407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty