Provider Demographics
NPI:1255107256
Name:ADORABLE SMILES PEDIATRIC DENTISTRY OF CORINTH
Entity type:Organization
Organization Name:ADORABLE SMILES PEDIATRIC DENTISTRY OF CORINTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:HAI
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:682-234-1111
Mailing Address - Street 1:3901 FM 2181 STE 140
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:TX
Mailing Address - Zip Code:76210-4250
Mailing Address - Country:US
Mailing Address - Phone:940-277-8760
Mailing Address - Fax:940-445-8109
Practice Address - Street 1:3901 FM 2181 STE 140
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76210-4250
Practice Address - Country:US
Practice Address - Phone:940-277-8760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty