# FRESH SMILES PLLC

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

## Provider details

- **NPI number:** 1417496415
- **Authorized official:** GAURAV PURI (OWNER DENTIST)
- **Authorized official phone:** (817) 451-4740

## Contact information

- **Practice address:** 2001 W. ST HWY 71, SUITE 20, LA GRANGE, TX 78945
- **Practice address phone:** (817) 451-4740
- **Mailing address:** 2001 W. ST HWY 71, SUITE 20, LA GRANGE, TX 78945

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 24365 | TX | Yes |

## Other

- **Enumeration date:** 02/23/2017
- **Last updated:** 02/23/2017