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General NPI Number Information
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NPI Number | 1750845228
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Entity Type | Organization
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Legal Business Name | SMILESBYMEHTA
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Dates
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Enumeration Date | 01/29/2019
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Last Update Date | 01/29/2019
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Provider Practice Location Address
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Address Line | 2201 THOMPSON RD STE 101
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City | RICHMOND
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State | TX
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Zip | 77469-5473
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Country | US
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Telephone | 201-214-5137
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Fax |
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Provider Business Mailing Address
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Address Line | 5250 BROWNWAY ST APT 2111
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City | HOUSTON
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State | TX
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Zip | 77056-4939
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Country | US
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Telephone | 201-214-5137
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. RADHIKA SHAH
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Credential |
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Telephone | 201-214-5137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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