Healthcare Provider Details

I. General information

NPI: 1265019202
Provider Name (Legal Business Name): CUDDLY SMILES PEDIATRIC DENTISTRY & ORTHODONTICS P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 04/10/2021
Certification Date: 04/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E BETHANY DR STE D
ALLEN TX
75002-4096
US

IV. Provider business mailing address

600 E BETHANY DR STE D
ALLEN TX
75002-4096
US

V. Phone/Fax

Practice location:
  • Phone: 469-342-0080
  • Fax: 469-342-0086
Mailing address:
  • Phone: 469-342-0080
  • Fax: 469-342-0086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. YVONNE AKOSUA FELLI
Title or Position: PEDIATRIC DENTIST/ OWNER
Credential: DMD
Phone: 956-771-8625