Organization
SISOMBATH DENTAL PC
Active
Other names
Prosper & Smile Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY SISOMBATH DDS (PRESIDENT)
(469) 296-8714
Entity
Organization
Contact information
Practice address
210 S PRESTON RD STE 60, PROSPER, TX 75078-2780
(469) 296-8714
Mailing address
5331 E MOCKINGBIRD LN APT 617, DALLAS, TX 75206-0911
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/24/2022
Last updated
01/24/2022
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