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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