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Organization
SMILE NINJA, PLLC
Active
Organization
SMILE NINJA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY MUND (CFO)
(817) 916-4431
Entity
Organization
Contact information
Practice address
220 E SEMINARY DR STE 100, FORT WORTH, TX 76115-2653
(817) 916-4431
Mailing address
220 E SEMINARY DR STE 100, FORT 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
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
09/28/2017
Last updated
08/26/2022
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