Provider Demographics
NPI:1194432625
Name:UR SMILE DENTAL ON HWY 6 PLLC
Entity type:Organization
Organization Name:UR SMILE DENTAL ON HWY 6 PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRASHANTH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAVI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:328-546-6363
Mailing Address - Street 1:19875 SOUTHWEST FWY STE 120
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3514
Mailing Address - Country:US
Mailing Address - Phone:832-546-6363
Mailing Address - Fax:
Practice Address - Street 1:4835 HIGHWAY 6 N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-2716
Practice Address - Country:US
Practice Address - Phone:281-463-9324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UR SMILE DENTAL GROUP PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty