Organization
COMFORT SMILES 9 PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEEPTI NAMINENI DDS (MANAGING MEMBER)
(646) 241-4964
Entity
Organization
Contact information
Practice address
8113 CAMP BOWIE WEST BLVD, FORT WORTH, TX 76116
(646) 241-4964
Mailing address
817 CALCOT DR, COPPELL, TX 75019-6610
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3005605
—
TX
Enumeration date
07/13/2021
Last updated
07/13/2021
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