MEDICARE: ISMILE 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	27905	TX

General Provider Information

NPI Number	:	1881944114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISMILE PC

Provider Business Mailing Address
First Line	:	3000 BISSONNET ST
Second Line	:	APT 5307
City	:	HOUSTON
State	:	TX
Zip	:	77005-4092
Country	:	US
Telephone Number	:	713-261-8311
Fax Number	:

Provider Business Practice Location Address
First Line	:	6434 HIGHWAY 6 N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-1310
Country	:	US
Telephone Number	:	352-682-1600
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MYOUNG HWANG
Credential	:	DDS
Telephone Number	:	713-261-8311

Provider Enumeration Date	:	09/13/2012
Last Update Date	:	09/13/2012

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Directions to “ISMILE PC ” Practice Location

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