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General NPI Number Information
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NPI Number | 1740489681
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Entity Type | Organization
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Legal Business Name | GROWING SMILES CHILDREN'S DENTAL CENTER
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 04/24/2018
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Provider Practice Location Address
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Address Line | 6800 N 10TH ST
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City | MCALLEN
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State | TX
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Zip | 78504-3293
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Country | US
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Telephone | 956-664-2244
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Fax | 956-664-9355
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Provider Business Mailing Address
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Address Line | 6800 N 10TH ST
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City | MCALLEN
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State | TX
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Zip | 78504-3293
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Country | US
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Telephone | 956-664-2244
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Fax | 956-664-9355
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARLOS NASSER MOHAMED
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Credential | D.D.S., M.P.H.
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Telephone | 956-664-2244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 022226
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License Number State | TX
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