Organization
MONA LISA SMILES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONA REZAPOUR DMD (DOCTOR/OWNER)
(702) 232-6551
Entity
Organization
Contact information
Practice address
15500 W HIGHWAY 71 STE 300, BEE CAVE, TX 78738-2813
(512) 900-2017
Mailing address
3100 MANCHACA RD APT 1, AUSTIN, TX 78704-6082
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
01/31/2018
Last updated
01/31/2018
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