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Organization
SMILE AND AESTHETIC 360
Active
Organization
SMILE AND AESTHETIC 360
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUVERIA FAKHRUDDIN DDS (CEO)
(219) 308-7221
Entity
Organization
Contact information
Practice address
2810 W FM 544 STE 100, WYLIE, TX 75098-7138
(972) 371-0441
Mailing address
3105 ROLLING HILLS LN, WYLIE, TX 75098-1379
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/09/2026
Last updated
06/09/2026
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