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Organization
SMILES HUT DENTAL
Active
Organization
SMILES HUT DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASHAN SALIM (MANAGER)
(972) 342-6359
Entity
Organization
Contact information
Practice address
4897 TX 121 SUITE 210, THE COLONY, TX 75056-4040
(972) 342-6359
Mailing address
4897 TX-121, SUITE#210, THE COLONY, TX 75056-4040
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J09083500057831
DRIVING LICENCE
NJ
Enumeration date
02/07/2020
Last updated
02/07/2020
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