Organization
SMART MOUTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA RIDER TROTTER DDS (OWNER/PEDIATRIC DENTIST)
(254) 399-9000
Entity
Organization
Contact information
Practice address
211 OLD HEWITT RD, WACO, TX 76712-6560
(254) 399-9000
(254) 399-9001
Mailing address
3119 RIVER PLACE DR, BELTON, TX 76513-1013
(254) 933-9826
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
16801
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134118870
INDIVIDUAL PROVIDER NPI
TX
Enumeration date
12/10/2013
Last updated
12/10/2013
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