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Organization
SPARKLE SMILES PLLC
Active
Organization
SPARKLE SMILES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAVAN CHILUVOJU (OWNER DENTIST)
(732) 423-4336
Entity
Organization
Contact information
Practice address
110 CHURCH ST, MARLIN, TX 76661
(732) 423-4336
Mailing address
110 CHURCH ST, MARLIN, TX 76661
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
28728
TX
Other
Enumeration date
09/02/2016
Last updated
09/02/2016
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