Provider Demographics
NPI:1063163293
Name:LOVE YOUR SMILE DENTISTRY, PLLC
Entity type:Organization
Organization Name:LOVE YOUR SMILE DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:CRAWFORD ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:469-351-6010
Mailing Address - Street 1:3365 REGENT BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3126
Mailing Address - Country:US
Mailing Address - Phone:469-351-6010
Mailing Address - Fax:469-351-6009
Practice Address - Street 1:3365 REGENT BLVD STE 120
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-3126
Practice Address - Country:US
Practice Address - Phone:469-351-6010
Practice Address - Fax:469-351-6009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental