Organization
PEDIATRIC SMILES P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANIVARA KRONE D.D.S. (PRESIDENT)
(817) 283-8600
Entity
Organization
Contact information
Practice address
3004 HIGHWAY 121, SUITE B, BEDFORD, TX 76021-4037
(817) 283-8600
(817) 283-8621
Mailing address
3004 HIGHWAY121, SUITE B, BEDFORD, TX 76021-4037
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
20602
TX
Other
Enumeration date
05/22/2007
Last updated
08/22/2020
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