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General NPI Number Information
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NPI Number | 1598547861
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Entity Type | Organization
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Legal Business Name | MYSMILE DENTISTRY PLLC
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 3044 OLD DENTON RD STE 126
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City | CARROLLTON
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State | TX
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Zip | 75007-5099
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Country | US
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Telephone | 763-772-5304
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Fax |
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Provider Business Mailing Address
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Address Line | 5931 ALPENROSE AVE
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City | FRISCO
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State | TX
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Zip | 75035-8009
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Country | US
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Telephone | 763-772-5304
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Fax |
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Authorized Official
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Title or Position | SOLE MEMEBER/DENTIST
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Name | MRS. TARANGINI SUGGALA
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Credential | DMD
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Telephone | 763-772-5304
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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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