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General NPI Number Information
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NPI Number | 1245599158
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Entity Type | Organization
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Legal Business Name | SMILE KINGS DENTAL & ORTHODONTICS, PLLC
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Dates
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Enumeration Date | 05/11/2012
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 210 S. ZARZAMORA
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City | SAN ANTONIO
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State | TX
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Zip | 78207
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Country | US
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Telephone | 210-236-9220
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Fax | 210-257-0399
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Provider Business Mailing Address
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Address Line | 210 S. ZARZAMORA
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City | SAN ANTONIO
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State | TX
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Zip | 78207
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Country | US
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Telephone | 210-236-9220
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Fax | 210-257-0399
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. PETER ZAKHARY
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Credential | DDS
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Telephone | 210-236-9220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 27312
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 27221
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License Number State | TX
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