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Organization
SHINY SMILE DENTAL
Active
Organization
SHINY SMILE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUSTAFA GHAZI ALSAFI DMD (DENTIST)
(312) 576-3948
Entity
Organization
Contact information
Practice address
1231 CAMBRIAN PARK CT, SUGAR LAND, TX 77479-5326
(312) 576-3948
Mailing address
1231 CAMBRIAN PARK CT, SUGAR LAND, TX 77479-5326
(312) 576-3948
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
31067
TX
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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