Provider Demographics
NPI:1174952584
Name:PURE SMILES
Entity type:Organization
Organization Name:PURE SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-647-7873
Mailing Address - Street 1:19235 KATY FREEWAY SOUTH
Mailing Address - Street 2:300A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094
Mailing Address - Country:US
Mailing Address - Phone:281-674-7873
Mailing Address - Fax:281-674-9997
Practice Address - Street 1:19235 KATY FREEWAY SOUTH
Practice Address - Street 2:300A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094
Practice Address - Country:US
Practice Address - Phone:281-674-7873
Practice Address - Fax:281-674-9997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX229941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty