Fiesta Smiles Pllc

NPI #1457711764 in Richmond, Texas

Provider Information

NPI Number: 1457711764
Entity Type: Organization
Organization Name: Fiesta Smiles Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 29, 2016
Last Updated: Feb 29, 2016

Practice Location

Address: 1301 FM 2218
Address 2: 500-B
City: Richmond
State: Texas
ZIP Code: 77469
Phone: (682) 234-4603

Authorized Official

Name: GAURAV PURI
Title: OWNER DENTIST
Phone: (682) 234-4603

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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