SMILE REVOLUTION PLLC NPI 1649787524

NPI Information

NPI: 1649787524
Provider Name: SMILE REVOLUTION PLLC

Doing Business As: GRAND CENTRAL DENTISTRY

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
600 S CONROE MEDICAL DRIVE
STE 104
CONROE, TX
ZIP 77304
Phone: (936) 666-4459
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SMILE REVOLUTION PLLC is a dental clinic center in Conroe, TX. SMILE REVOLUTION PLLC NPI is 1649787524. The provider is registered as an organization entity type.
The provider Is Doing Business As Grand Central Dentistry.

The provider's business location address is:

600 S CONROE MEDICAL DRIVE
STE 104
CONROE, TX
ZIP 77304
Phone: (936) 666-4459

The provider's authorized official is Shivani Patel .
The authorized official title is Owner and has the following contact phone number (936) 666-4459.

The enumeration date for this NPI number is 1/2/2018 and was last updated on 1/2/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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