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General NPI Number Information
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NPI Number | 1427795368
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Entity Type | Organization
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Legal Business Name | CONFIDENT SMILE STUDIO, PLLC
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Dates
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Enumeration Date | 05/12/2022
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 6780 ABRAMS RD STE 111
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City | DALLAS
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State | TX
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Zip | 75231-0229
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Country | US
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Telephone | 214-888-6726
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Fax |
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Provider Business Mailing Address
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Address Line | 2362 OLDBRIDGE DR
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City | DALLAS
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State | TX
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Zip | 75228-5360
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Country | US
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Telephone | 972-816-8861
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KENECHUKWU DIJON NWANKWO
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Credential | DDS
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Telephone | 972-816-8861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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