Organization
HEALTHY SMILES 4 KIDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN RALSTON GOBER DDS (DENTIST/OWNER)
(817) 428-8575
Entity
Organization
Contact information
Practice address
5708 COLLEYVILLE BLVD, SUITE A, COLLEYVILLE, TX 76034-6064
(817) 428-8575
(817) 577-3970
Mailing address
5708 COLLEYVILLE BLVD, SUITE A, COLLEYVILLE, TX 76034-6064
(817) 428-8575
(817) 577-3970
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
16709
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091175202
—
TX
05
—
091175203
—
TX
Enumeration date
08/26/2015
Last updated
08/26/2015
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