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General NPI Number Information
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NPI Number | 1003776188
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Entity Type | Organization
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Legal Business Name | TROPHY CLUB SMILES PLLC
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Dates
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Enumeration Date | 11/12/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 2240 TX-114 SUITE 650
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City | TROPHY CLUB
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State | TX
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Zip | 76262
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Country | US
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Telephone | 732-763-4329
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Fax |
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Provider Business Mailing Address
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Address Line | 2240 TX-114 SUITE 650
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City | TROPHY CLUB
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State | TX
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Zip | 76262
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | MARRIUM HAROON
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Credential | DDS
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Telephone | 732-763-4329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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