# 4TH STREET DENTAL, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Smiles of Lubbock
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306347711
- **Authorized official:** CRIAG FLEMING COPELAND DMD (OWNER/DMD)
- **Authorized official phone:** (940) 220-7833

## Contact information

- **Practice address:** 5709 4TH ST, LUBBOCK, TX 79416
- **Practice address phone:** (940) 220-7833
- **Mailing address:** 3600 E MCKINNEY ST STE 100, DENTON, TX 76209-7557
- **Mailing address phone:** (940) 312-5626

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 25735 | TX | Yes |

## Other

- **Enumeration date:** 02/22/2018
- **Last updated:** 07/27/2018