Healthcare Provider Details

I. General information

NPI: 1427262575
Provider Name (Legal Business Name): CELEBRITY SMILE COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7439 SOUTHWEST FREEWAY
HOUSTON TX
77074
US

IV. Provider business mailing address

7439 SOUTHWEST FREEWAY
HOUSTON TX
77074
US

V. Phone/Fax

Practice location:
  • Phone: 713-271-9555
  • Fax: 713-271-9557
Mailing address:
  • Phone: 713-271-9555
  • Fax: 713-271-9557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number21179
License Number StateTX

VIII. Authorized Official

Name: DR. VI G HUYNH
Title or Position: PRESIDENT
Credential: DMD
Phone: 713-271-9555