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General NPI Number Information
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NPI Number | 1174952584
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Entity Type | Organization
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Legal Business Name | PURE SMILES
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Dates
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Enumeration Date | 11/06/2013
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 19235 KATY FREEWAY SOUTH 300A
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City | HOUSTON
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State | TX
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Zip | 77094
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Country | US
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Telephone | 281-674-7873
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Fax | 281-674-9997
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Provider Business Mailing Address
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Address Line | 19235 KATY FREEWAY SOUTH 300A
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City | HOUSTON
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State | TX
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Zip | 77094
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Country | US
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Telephone | 281-674-7873
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Fax | 281-674-9997
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. ANGELINA YAP
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Credential | DDS
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Telephone | 281-647-7873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22994
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License Number State | TX
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