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Organization
UNITED SMILE CENTER PA
Active
Organization
UNITED SMILE CENTER PA
Active
Other names
CELINA FAMILY DENTISTRY
Organization subpart
No
Provider details
NPI number
Authorized official
DOROTHY HERNANDEZ (CREDENTIALING AGENT)
(928) 779-4404
Entity
Organization
Contact information
Practice address
3248 S PRESTON RD STE 140, CELINA, TX 75009-3899
(214) 851-0130
(214) 851-0111
Mailing address
3248 S PRESTON RD STE 140, CELINA, TX 75009-3899
(214) 851-0130
(214) 851-0111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
23268
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23268
1972795532
TX
Enumeration date
12/19/2017
Last updated
06/16/2018
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