Organization
ORTHODONTIC SMILE DESIGN, PC
Active
Organization
ORTHODONTIC SMILE DESIGN, PC
Active
Other names
Smile Design Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
FERNAN RODRIGUEZ D.D.S, M.S. (PRESIDENT)
(972) 263-1755
Entity
Organization
Contact information
Practice address
325 W WESTCHESTER PKWY, SUITE 100, GRAND PRAIRIE, TX 75052-2857
(972) 263-1755
(972) 264-6226
Mailing address
325 W WESTCHESTER PKWY, SUITE 100, GRAND PRAIRIE, TX 75052-2857
(972) 263-1755
(972) 264-6226
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
21607
TX
Other
Enumeration date
12/21/2015
Last updated
12/21/2015
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