Healthcare Provider Details

I. General information

NPI: 1407310824
Provider Name (Legal Business Name): HUFFMAN SMILES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2019
Last Update Date: 01/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24110 FM 2100 RD
HUFFMAN TX
77336-2636
US

IV. Provider business mailing address

14623 HAMPTON GREEN LN
HOUSTON TX
77044-5789
US

V. Phone/Fax

Practice location:
  • Phone: 832-369-6775
  • Fax:
Mailing address:
  • Phone: 832-369-6775
  • 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: MR. ABHINAV RASTOGI
Title or Position: CEO
Credential:
Phone: 832-369-6775