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General NPI Number Information
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NPI Number | 1710105549
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Entity Type | Organization
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Legal Business Name | NATURAL SMILE DENTISTRY
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 01/25/2010
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Provider Practice Location Address
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Address Line | 4032 MCDERMOTT RD STE 200
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City | PLANO
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State | TX
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Zip | 75024-7738
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Country | US
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Telephone | 214-618-6250
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Fax | 972-692-8224
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Provider Business Mailing Address
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Address Line | 4032 MCDERMOTT RD STE 200
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City | PLANO
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State | TX
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Zip | 75024-7738
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Country | US
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Telephone | 214-618-6250
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Fax | 972-692-8224
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Authorized Official
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Title or Position | DENTIST
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Name | DR. PRIYA MAINKER
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Credential | D.M.D
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Telephone | 214-618-6250
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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 | 19972
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License Number State | TX
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