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General NPI Number Information
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NPI Number | 1134501992
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Entity Type | Organization
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Legal Business Name | KK SMILES ASSOCIATES PLLC
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Dates
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Enumeration Date | 06/28/2015
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Last Update Date | 06/28/2015
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Provider Practice Location Address
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Address Line | 900 PECAN ST E SUITE 500
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-8048
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Country | US
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Telephone | 817-914-3594
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Fax |
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Provider Business Mailing Address
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Address Line | 900 PECAN ST E SUITE 500
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-8048
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Country | US
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Telephone | 817-914-3594
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KEYUYRKUMAR PATEL
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Credential |
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Telephone | 817-914-3594
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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 | 29242
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License Number State | TX
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