MEDICARE: SPRING SMILES, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1174299119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRING SMILES, PC

Provider Business Mailing Address
First Line	:	3301 TIDWELL RD STE D
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77093-6830
Country	:	US
Telephone Number	:	832-564-1800
Fax Number	:	832-564-1806

Provider Business Practice Location Address
First Line	:	7312 LOUETTA RD STE B119
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-6176
Country	:	US
Telephone Number	:	281-370-3323
Fax Number	:	281-305-7437

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JUNI GARZA
Credential	:
Telephone Number	:	832-564-1800

Provider Enumeration Date	:	08/19/2021
Last Update Date	:	08/19/2021

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