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General NPI Number Information
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NPI Number | 1740585173
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Entity Type | Organization
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Legal Business Name | SMILE ARTIST DENTISTRY PLLC
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Dates
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Enumeration Date | 01/15/2011
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Last Update Date | 01/15/2011
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Provider Practice Location Address
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Address Line | 10065 ALMEDA GENOA RD STE J
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City | HOUSTON
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State | TX
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Zip | 77075-2417
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Country | US
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Telephone | 832-308-1921
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Fax | 832-308-1925
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Provider Business Mailing Address
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Address Line | 11014 LINDEN GATE DR
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City | HOUSTON
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State | TX
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Zip | 77075-2440
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Country | US
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Telephone | 832-308-1921
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/DENTIST
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Name | DR. RODRIGO CABRERA
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Credential | DDS
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Telephone | 713-899-1789
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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 | 23862
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License Number State | TX
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