Organization
WESTLAKE DENTAL PA
Active
Organization
WESTLAKE DENTAL PA
Active
Other names
Smithson Valley Dental Professionals
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD BRIAN SMITH D.O (OWNER)
(830) 980-1800
Entity
Organization
Contact information
Practice address
20450 STATE HIGHWAY 46 W, SUITE 400, SPRING BRANCH, TX 78070-6130
(830) 980-1800
Mailing address
20450 STATE HIGHWAY 46 W, SUITE 400, SPRING BRANCH, TX 78070-6130
(830) 980-1800
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
14120
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
13408
TX
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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