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General NPI Number Information
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NPI Number | 1942089826
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Entity Type | Organization
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Legal Business Name | SMITH DENTAL SLEEP MEDICINE PLLC
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Dates
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Enumeration Date | 09/28/2023
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 308 S BRYAN RD
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City | MISSION
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State | TX
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Zip | 78572-6222
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Country | US
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Telephone | 956-739-9504
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Fax |
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Provider Business Mailing Address
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Address Line | 308 S BRYAN RD
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City | MISSION
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State | TX
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Zip | 78572-6222
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Country | US
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Telephone | 956-739-9504
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW SMITH
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Credential |
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Telephone | 956-739-9504
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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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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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