Organization
SMILE BAR PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLE KOSTIUK DMD (DENTIST)
(941) 875-7002
Entity
Organization
Contact information
Practice address
9901 BRODIE LN STE 130, AUSTIN, TX 78748-5889
(737) 204-7208
Mailing address
7329 CORDOBA DR, AUSTIN, TX 78724-6251
(941) 875-7002
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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