Provider Demographics
NPI:1124793328
Name:ARLINGTON CAMPUS SMILES PLLC
Entity type:Organization
Organization Name:ARLINGTON CAMPUS SMILES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:626-226-8119
Mailing Address - Street 1:1725 CIMARRON TRL STE 3B
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3439
Mailing Address - Country:US
Mailing Address - Phone:817-280-0099
Mailing Address - Fax:817-280-0377
Practice Address - Street 1:1725 CIMARRON TRL STE 3B
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3439
Practice Address - Country:US
Practice Address - Phone:817-280-0099
Practice Address - Fax:817-280-0377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-11
Last Update Date:2022-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental