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General NPI Number Information
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NPI Number | 1790222685
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Entity Type | Organization
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Legal Business Name | MADE YA SMILE RAYFORD CROSSING, PLLC
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Dates
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Enumeration Date | 01/30/2017
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Last Update Date | 01/30/2017
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Provider Practice Location Address
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Address Line | 2833 RILEY FUZZELL RD SUITE 700
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City | SPRING
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State | TX
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Zip | 77386-2806
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Country | US
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Telephone | 281-566-2813
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Fax | 281-566-2861
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Provider Business Mailing Address
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Address Line | 1449 HIGHWAY 6 SUITE 320
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City | SUGAR LAND
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State | TX
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Zip | 77478-5145
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Country | US
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Telephone | 281-265-1111
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Fax | 281-566-2720
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. MICHAEL L KESNER
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Credential | D.D.S.
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Telephone | 281-265-1111
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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 | 14415
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License Number State | TX
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