# ADVANCED SMILE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104154251
- **Authorized official:** FATEMEH SAMANI (DDS)
- **Authorized official phone:** (512) 244-7677

## Contact information

- **Practice address:** 3407 WELLS BRANCH PKWY STE 700, AUSTIN, TX 78728-6619
- **Practice address phone:** (512) 244-7677
- **Practice address fax:** (512) 244-9672
- **Mailing address:** 3407 WELLS BRANCH PKWY STE 700, AUSTIN, TX 78728-6619
- **Mailing address phone:** (512) 244-7677
- **Mailing address fax:** (512) 244-9672

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 16589 | TX | Yes |

## Other

- **Enumeration date:** 12/01/2009
- **Last updated:** 12/01/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 16598 | — | TX |