Healthcare Provider Details
I. General information
NPI: 1669093068
Provider Name (Legal Business Name): SMILEY DENTAL SINGLETON PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/27/2020
Last Update Date: 04/27/2020
Certification Date: 04/27/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2223 SINGLETON BLVD STE 212
DALLAS TX
75212-3784
US
IV. Provider business mailing address
PO BOX 450758
GARLAND TX
75045-0758
US
V. Phone/Fax
- Phone: 214-466-1400
- Fax: 214-367-5896
- Phone: 214-466-1400
- Fax: 214-367-5896
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LYNHTHY
T
PHAM
Title or Position: OWNER
Credential: DDS
Phone: 214-466-1400