# MOUNTAIN SMILES - MANSELL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730084377
- **Authorized official:** ANGEL GEMINEZ (CREDENTIALING MANAGER)
- **Authorized official phone:** (719) 300-5933

## Contact information

- **Practice address:** 8101 THOMPSON RD, NORTHLAKE, TX 76247-6203
- **Practice address phone:** (940) 648-3384
- **Mailing address:** 8101 THOMPSON RD, NORTHLAKE, TX 76247-6203
- **Mailing address phone:** (940) 648-3384

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/13/2026
- **Last updated:** 10/13/2026