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General NPI Number Information
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NPI Number | 1275253494
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Entity Type | Organization
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Legal Business Name | SEA SMILES ORTHODONTICS, PLLC
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 3500 LITTLE YORK RD STE A1
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City | HOUSTON
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State | TX
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Zip | 77093-3600
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Country | US
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Telephone | 713-766-3352
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 LAKEVIEW PKWY
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City | ALPHARETTA
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State | GA
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Zip | 30009-9082
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Country | US
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Telephone | 727-784-2721
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL KHORRAMIAN
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Credential | DDS
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Telephone | 727-784-2721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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