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General NPI Number Information
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NPI Number | 1255951802
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Entity Type | Organization
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Legal Business Name | SMILEGIVERS PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/23/2020
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | 8725 MARBACH RD STE 201
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City | SAN ANTONIO
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State | TX
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Zip | 78227-2378
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Country | US
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Telephone | 210-495-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 8725 MARBACH RD STE 201
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City | SAN ANTONIO
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State | TX
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Zip | 78227-2378
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Country | US
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Telephone | 210-495-2222
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DANIEL SEMUHA
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Credential |
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Telephone | 818-430-1110
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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 |
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License Number State |
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