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General NPI Number Information
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NPI Number | 1568039840
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Entity Type | Organization
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Legal Business Name | THE SMILE FACTORY DENTAL & ORTHODONTICS, PLLC
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Dates
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Enumeration Date | 06/07/2021
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Last Update Date | 06/07/2021
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Provider Practice Location Address
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Address Line | 2628 MATLOCK RD
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City | ARLINGTON
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State | TX
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Zip | 76015-2525
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Country | US
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Telephone | 817-617-2860
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Fax |
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Provider Business Mailing Address
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Address Line | 10061 RIVERSIDE DR # 722
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City | TOLUCA LAKE
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State | CA
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Zip | 91602-2560
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Country | US
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Telephone | 469-348-8870
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. RICHARD MALOUF
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Credential | DDS
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Telephone | 469-348-8870
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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 |
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License Number State |
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Taxonomy #2
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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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