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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