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Organization
PECAN DENTAL AND IMPLANT SOLUTIONS LLC
Active
Organization
PECAN DENTAL AND IMPLANT SOLUTIONS LLC
Active
Other names
Smile Makeover
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSAMA SIDDIQUI DMD (OWNER)
(469) 781-0231
Entity
Organization
Contact information
Practice address
670 W CAMPBELL RD, RICHARDSON, TX 75080-3393
(414) 630-7384
Mailing address
670 W CAMPBELL RD, RICHARDSON, TX 75080-3393
(414) 630-7384
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
03/15/2021
Last updated
11/15/2023
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