# FANTASTIC SMILES OF HOUSTON PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fantastic Smiles of Houston
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164390464
- **Authorized official:** JENNY GARCIA (PAYER ENROLLMENT MANAGER)
- **Authorized official phone:** (972) 869-3789

## Contact information

- **Practice address:** 2617 W HOLCOMBE BLVD STE 1, HOUSTON, TX 77025-1757
- **Practice address phone:** (832) 862-1111
- **Practice address fax:** (832) 487-9247
- **Mailing address:** 2617 W HOLCOMBE BLVD STE 1, HOUSTON, TX 77025-1757
- **Mailing address phone:** (832) 862-1111
- **Mailing address fax:** (832) 487-9247

## Taxonomy

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

## Other

- **Enumeration date:** 10/28/2025
- **Last updated:** 10/28/2025