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Organization
ISMILE FAMILY DENTAL PA
Active
Organization
ISMILE FAMILY DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUJATHA TELLA DDS (DIRECTOR)
(214) 620-7445
Entity
Organization
Contact information
Practice address
825 WEST ROYAL LANE, STE 210, IRVING, TX 75039
(214) 620-7445
Mailing address
108 SAN GABRIEL DR, IRVING, TX 75039-3350
(214) 620-7445
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23445
TX
Other
Enumeration date
07/17/2012
Last updated
07/17/2012
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