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Organization
PROSPER SMILES PLLC
Active
Organization
PROSPER SMILES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIMAL PATEL (MANAGING MEMBER/PRESIDENT)
(402) 650-7405
Entity
Organization
Contact information
Practice address
821 N COLEMAN ST, SUITE 120, PROSPER, TX 75078-2303
(972) 347-9617
Mailing address
821 N COLEMAN ST, SUITE 120, PROSPER, TX 75078-2303
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
27680
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
19056
TX
Other
Enumeration date
05/18/2015
Last updated
05/18/2015
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