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General NPI Number Information
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NPI Number | 1245504695
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Entity Type | Organization
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Legal Business Name | SMILE & SHINE,PLLC
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Dates
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Enumeration Date | 03/02/2012
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Last Update Date | 04/12/2013
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Provider Practice Location Address
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Address Line | 5326 E US HIGHWAY 83 A3
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-9409
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Country | US
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Telephone | 956-263-1222
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Fax | 956-263-1566
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Provider Business Mailing Address
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Address Line | 5326 E US HIGHWAY 83 A3
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-9409
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Country | US
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Telephone | 956-263-1222
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Fax | 956-263-1566
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Authorized Official
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Title or Position | MEMBER
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Name | DR. HARJAP SINGH NANVA
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Credential | DDS
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Telephone | 956-263-1222
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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 | 24586
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License Number State | TX
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