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General NPI Number Information
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NPI Number | 1447681606
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Entity Type | Organization
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Legal Business Name | SMILE KINGS BANDERA, PLLC
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Dates
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Enumeration Date | 12/12/2013
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 919 BANDERA RD. STE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78228
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Country | US
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Telephone | 210-774-6186
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Fax | 210-787-2166
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Provider Business Mailing Address
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Address Line | 919 BANDERA RD. STE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78228
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Country | US
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Telephone | 210-774-6186
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Fax | 210-787-2166
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. ALI TORBATI
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Credential | DDS
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Telephone | 210-774-6186
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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 | 27312
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License Number State | TX
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