Organization
AMERISMILES INC
Active
Other names
Live oak Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUMAN R NALLA DMD (DIRECTOR)
(603) 233-1889
Entity
Organization
Contact information
Practice address
3310 LIVE OAK ST, SUITE 200, DALLAS, TX 75204-6153
(214) 827-1305
Mailing address
3310 LIVE OAK ST, SUITE 200, DALLAS, TX 75204-6153
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
25949
TX
Other
Enumeration date
12/29/2010
Last updated
12/29/2010
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