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NPI Code Detail

MEDICARE: MOBILE SMILES OF TEXAS

MEDICARE: MOBILE SMILES OF TEXAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1689951196
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOBILE SMILES OF TEXAS
Provider Business Mailing Address
First Line : 6107 MARTEL AVE
Second Line :
City : DALLAS
State : TX
Zip : 75214-3025
Country : US
Telephone Number : 936-554-0669
Fax Number : 936-598-6412
Provider Business Practice Location Address
First Line : 6107 MARTEL AVE
Second Line :
City : DALLAS
State : TX
Zip : 75214-3025
Country : US
Telephone Number : 936-554-0996
Fax Number : 936-598-6412
Authorized Official
Title or Position : PRESIDENT
Name : DR. ANNA JOY WINDHAM SHIRLEY
Credential : DDS
Telephone Number : 936-554-0996
Provider Enumeration Date : 11/11/2011
Last Update Date : 11/11/2011

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Directions to “MOBILE SMILES OF TEXAS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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