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General NPI Number Information
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NPI Number | 1346338654
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Entity Type | Organization
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Legal Business Name | COSMETIC SMILE DESIGNS
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 407 EAST PARKWOOD
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City | FRIENDSWOOD
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State | TX
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Zip | 77546
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Country | US
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Telephone | 281-992-3368
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Fax | 281-992-2291
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Provider Business Mailing Address
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Address Line | 407 EAST PARKWOOD
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City | FRIENDSWOOD
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State | TX
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Zip | 77546
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Country | US
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Telephone | 281-992-3368
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Fax | 281-992-2291
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Authorized Official
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Title or Position | DDS
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Name | DR. RICHARD G SPARKS
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Credential | DDS
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Telephone | 281-992-3368
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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 | 18708
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License Number State | TX
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