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General NPI Number Information
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NPI Number | 1578892733
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Entity Type | Organization
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Legal Business Name | GOODSMILES DENTAL, PLLC
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Dates
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Enumeration Date | 12/17/2009
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Last Update Date | 12/17/2009
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Provider Practice Location Address
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Address Line | 2535 E ARKANSAS LN SUITE 339-341
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City | ARLINGTON
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State | TX
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Zip | 76010-8797
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Country | US
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Telephone | 408-431-7258
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Fax |
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Provider Business Mailing Address
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Address Line | 3212 PAMPLONA
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City | GRAND PRAIRIE
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State | TX
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Zip | 75054-6859
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Country | US
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Telephone | 408-431-7258
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD HO
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Credential | D.M.D
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Telephone | 408-431-7258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 23749
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License Number State | TX
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