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General NPI Number Information
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NPI Number | 1962220590
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Entity Type | Organization
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Legal Business Name | JL SMILE DENTISTRY
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 27104 TX HWY 249 BLDG B STE B.800
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City | TOMBALL
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State | TX
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Zip | 77375
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Country | US
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Telephone | 281-826-5131
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Fax | 281-826-5283
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Provider Business Mailing Address
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Address Line | 1011 GREEN KENSINGTON DR
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City | HOUSTON
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State | TX
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Zip | 77008-1090
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Country | US
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Telephone | 972-786-6920
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN JAE WOO LEE
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Credential | DDS
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Telephone | 972-786-6920
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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