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General NPI Number Information
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NPI Number | 1053109298
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Entity Type | Organization
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Legal Business Name | RESTORE SMILES DENTISTRY OF TOMBALL
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Dates
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Enumeration Date | 04/28/2025
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 21941 ROSEHILL RESERVE DRIVE SUITE 104
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City | TOMBALL
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State | TX
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Zip | 77377
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Country | US
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Telephone | 281-720-3334
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Fax |
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Provider Business Mailing Address
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Address Line | 21941 ROSEHILL RESERVE DRIVE SUITE 104
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City | TOMBALL
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State | TX
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Zip | 77377
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Country | US
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Telephone | 228-365-0747
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. KIMBERLY TRUONG
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Credential | DDS
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Telephone | 228-365-0747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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