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Organization
SENIOR SMILES PA
Active
Organization
SENIOR SMILES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY KON DDS (PRESIDENT & OWNER)
(512) 381-5572
Entity
Organization
Contact information
Practice address
2550 S IH 35, SUITE 215, AUSTIN, TX 78704-5722
(512) 381-5572
(888) 503-5605
Mailing address
PO BOX 41266, AUSTIN, TX 78704-0022
(512) 381-5572
(888) 503-5605
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
25128
TX
Other
Enumeration date
01/29/2015
Last updated
01/29/2015
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