Provider Demographics
NPI:1124845250
Name:PROFESSIONAL SMILES PLLC
Entity type:Organization
Organization Name:PROFESSIONAL SMILES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-251-5873
Mailing Address - Street 1:18321 W AIRPORT BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-5030
Mailing Address - Country:US
Mailing Address - Phone:346-620-1535
Mailing Address - Fax:
Practice Address - Street 1:18321 W AIRPORT BLVD STE 105
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-5030
Practice Address - Country:US
Practice Address - Phone:346-620-1535
Practice Address - Fax:346-843-8004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-20
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty