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Organization
GREAT EXPRESSION SMILES
Active
Organization
GREAT EXPRESSION SMILES
Active
Other names
Great Expression Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRI PHAM DDS (PRESIDENT)
(817) 496-2343
Entity
Organization
Contact information
Practice address
200 E MAIN ST STE C, CROWLEY, TX 76036-2600
(817) 297-4068
(817) 665-3822
Mailing address
200 E MAIN ST STE C, CROWLEY, TX 76036-2600
(817) 297-4068
(817) 665-3822
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202009121
—
TX
Enumeration date
05/13/2014
Last updated
05/13/2014
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