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General NPI Number Information
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NPI Number | 1528627916
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Entity Type | Organization
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Legal Business Name | PETITE SMILES PEDIATRIC DENTISTRY, PLLC
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Dates
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Enumeration Date | 06/10/2019
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Last Update Date | 06/10/2019
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Provider Practice Location Address
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Address Line | 11131 HARLEM RD, SUITE 120
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City | RICHMOND
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State | TX
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Zip | 77406
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Country | US
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Telephone | 832-271-6114
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Fax |
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Provider Business Mailing Address
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Address Line | 5341 VAL VERDE ST
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City | HOUSTON
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State | TX
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Zip | 77056-6220
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGING MEMBER
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Name | DR. MAYURI APPAREDDY
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Credential | DMD
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Telephone | 832-271-6114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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