Healthcare Provider Details

I. General information

NPI: 1841847506
Provider Name (Legal Business Name): HAPPY DENTAL SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2019
Last Update Date: 08/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 JESUS CARRANZA
NUEVO LAREDO TAMAULIPAS
88040
MX

IV. Provider business mailing address

110 CARDINAL LN
LAREDO TX
78045-4150
US

V. Phone/Fax

Practice location:
  • Phone: 956-267-4983
  • Fax:
Mailing address:
  • Phone: 956-267-4983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. LUIS TREVINO
Title or Position: OWNER
Credential: DDS
Phone: 956-267-4983