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General NPI Number Information
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NPI Number | 1720526825
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Entity Type | Organization
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Legal Business Name | PRESTIGIOUS SMILES LLC
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Dates
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Enumeration Date | 02/08/2017
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Last Update Date | 02/08/2017
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Provider Practice Location Address
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Address Line | 14119 STUEBNER AIRLINE RD
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City | HOUSTON
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State | TX
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Zip | 77069-3525
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Country | US
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Telephone | 281-880-6666
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Fax | 832-446-3472
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Provider Business Mailing Address
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Address Line | 14119 STUEBNER AIRLINE RD
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City | HOUSTON
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State | TX
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Zip | 77069-3525
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Country | US
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Telephone | 281-880-6666
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Fax | 832-446-3472
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Authorized Official
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Title or Position | PRESIDENT
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Name | AREZO ZARGHOUNI
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Credential | DDS
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Telephone | 281-880-6666
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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 | 32624
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 20963
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License Number State | TX
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