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General NPI Number Information
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NPI Number | 1417445388
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Entity Type | Organization
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Legal Business Name | SERENE SMILES DENTISTRY PLLC
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 03/01/2021
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Provider Practice Location Address
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Address Line | 951 W ROUND GROVE RD STE 300
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City | LEWISVILLE
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State | TX
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Zip | 75067-7902
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Country | US
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Telephone | 732-939-9236
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Fax |
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Provider Business Mailing Address
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Address Line | 951 W ROUND GROVE RD STE 300
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City | LEWISVILLE
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State | TX
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Zip | 75067-7902
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Country | US
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Telephone | 469-702-2250
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHILPA S AGADI
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Credential | DDS
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Telephone | 469-702-2250
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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 | 30872
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License Number State | TX
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