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Organization

SMILE ISLAND DENTAL, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER WEEMS (OFFICE MANAGER)
(972) 378-6762
Entity
Organization

Contact information

Practice address
6513 PRESTON RD, SUITE 500, PLANO, TX 75024-2688
(972) 378-6762
(972) 378-6771
Mailing address
6513 PRESTON RD, SUITE 500, PLANO, TX 75024-2688
(972) 378-6762
(972) 378-6771

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
16742
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1583841-01
TX
Enumeration date
06/04/2008
Last updated
02/09/2012
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