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General NPI Number Information
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NPI Number | 1891133211
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Entity Type | Organization
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Legal Business Name | A NEW SMILE DENTAL PLLC
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Dates
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Enumeration Date | 06/07/2013
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Last Update Date | 06/07/2013
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Provider Practice Location Address
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Address Line | 14829 BELLAIRE BLVD STE 1B
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City | HOUSTON
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State | TX
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Zip | 77083-2500
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Country | US
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Telephone | 281-495-7018
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Fax |
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Provider Business Mailing Address
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Address Line | 6318 HIDDEN CREST WAY
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City | SUGAR LAND
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State | TX
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Zip | 77479-5583
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Country | US
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Telephone | 860-849-9740
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BO WANG
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Credential | D.M.D.
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Telephone | 860-849-9740
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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 | 24384
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License Number State | TX
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