Organization
AFFINITY SMILES DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHUONG DO DDS (MEMBER/MANAGER)
(817) 966-0648
Entity
Organization
Contact information
Practice address
1112 N HIGHWAY 377 STE 106, ROANOKE, TX 76262-9125
(817) 966-0648
Mailing address
1112 N HIGHWAY 377 STE 106, ROANOKE, TX 76262-9125
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/07/2009
Last updated
01/07/2009
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