Organization
FORT WORTH SMILE STUDIO P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO MIRANDA D.D.S (DENTIST)
(817) 263-9014
Entity
Organization
Contact information
Practice address
6115 S HULEN ST, FORT WORTH, TX 76133-3403
(817) 236-9014
(817) 263-7081
Mailing address
6115 S HULEN ST, FORT WORTH, TX 76133-3403
(817) 236-9014
(817) 263-7081
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/05/2015
Last updated
02/05/2015
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