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General NPI Number Information
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NPI Number | 1700085669
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Entity Type | Organization
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Legal Business Name | SMILES FOR YOU, PLLC
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 04/06/2011
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Provider Practice Location Address
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Address Line | 2350 HALL JOHNSON ROAD SUITE #105
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City | GRAPEVINE
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State | TX
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Zip | 76051-6589
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Country | US
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Telephone | 817-481-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 2350 HALL JOHNSON RD SUITE #105
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City | GRAPEVINE
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State | TX
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Zip | 76051-6589
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Country | US
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Telephone | 817-681-7680
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARIA NIVEDITAJOUVITA FERNANDES-MORAIS
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Credential | D.M.D.
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Telephone | 817-681-7680
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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 | 21650
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License Number State | TX
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