Wichita Smiles

NPI #1154708162 in Wichita Falls, Texas

Provider Information

NPI Number: 1154708162
Entity Type: Organization
Organization Name: Wichita Smiles
Primary Specialty: Dentist
Enumeration Date: Apr 28, 2015
Last Updated: Apr 28, 2015

Practice Location

Address: 2120 VIRGINIA DR STE A
City: Wichita Falls
State: Texas
ZIP Code: 76309-4646
Phone: (940) 761-5979

Authorized Official

Name: DR. JEFFREY BULLOCK JOHNSON, DDS
Title: DENTIST
Phone: (940) 761-5979

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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