# KELLER SMILES LLC

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

## Provider details

- **NPI number:** 1104478635
- **Authorized official:** MR. JESUS ALVARADO (OFFICE MANAGER)
- **Authorized official phone:** (682) 593-0993

## Contact information

- **Practice address:** 1540 KELLER PKWY STE 140, KELLER, TX 76248-3685
- **Practice address phone:** (682) 593-0993
- **Practice address fax:** (682) 593-0995
- **Mailing address:** PO BOX 4400, SALEM, OR 97302-8400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/15/2019
- **Last updated:** 07/15/2019