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Organization
FORT WORTH SMILEBAR PLLC
Active
Organization
FORT WORTH SMILEBAR PLLC
Active
Parent organization
SMILE NINJA, PLLC
Other names
Smile Ninja Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
SMILE NINJA, PLLC
Authorized official
JUSTIN D MUND DDS (OWNER)
(817) 916-4431
Entity
Organization
Contact information
Practice address
550 ALTA MERE DR, FORT WORTH, TX 76114-4053
(817) 286-0044
Mailing address
220 E SEMINARY DR STE 100, FT WORTH, TX 76115-2653
(817) 916-4431
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
02/13/2020
Last updated
02/13/2020
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