Organization
SECOND IMPRESSION SMILES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TANAYA CLAIBORNE SANDERS DDS (CO-OWNER/ DENTIST)
(214) 929-4728
Entity
Organization
Contact information
Practice address
1705 FOUNTAINVIEW DR STE 105, MANSFIELD, TX 76063-7808
(682) 232-4335
Mailing address
1705 FOUNTAINVIEW DR STE 105, MANSFIELD, TX 76063-7808
(682) 232-4335
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568782274
ALIX H. SANDERS JR. DDS
—
Enumeration date
07/26/2024
Last updated
07/26/2024
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