Provider Demographics
NPI:1326847740
Name:SMILE MUSE DENTISTRY PLLC
Entity type:Organization
Organization Name:SMILE MUSE DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUNT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-681-6419
Mailing Address - Street 1:8305 SOUTHRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-8494
Mailing Address - Country:US
Mailing Address - Phone:501-442-8585
Mailing Address - Fax:
Practice Address - Street 1:9705 TEHAMA RIDGE PKWY STE 149
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76177-7523
Practice Address - Country:US
Practice Address - Phone:214-699-7451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental