Super Smiles Dental

NPI #1558552364 in Mesquite, Texas

Provider Information

NPI Number: 1558552364
Entity Type: Organization
Organization Name: Super Smiles Dental
Primary Specialty: Dentist
Enumeration Date: Aug 6, 2007
Last Updated: Aug 6, 2007

Practice Location

Address: 2110 N GALLOWAY AVE STE 120
City: Mesquite
State: Texas
ZIP Code: 75150-5738
Phone: (972) 216-0300

Authorized Official

Name: MARY PU
Title: GENERAL MANAGER
Phone: (817) 675-8753

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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