Provider Demographics
NPI:1427795368
Name:CONFIDENT SMILE STUDIO, PLLC
Entity type:Organization
Organization Name:CONFIDENT SMILE STUDIO, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KENECHUKWU
Authorized Official - Middle Name:DIJON
Authorized Official - Last Name:NWANKWO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-816-8861
Mailing Address - Street 1:2362 OLDBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-5360
Mailing Address - Country:US
Mailing Address - Phone:972-816-8861
Mailing Address - Fax:
Practice Address - Street 1:6780 ABRAMS RD STE 111
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0229
Practice Address - Country:US
Practice Address - Phone:214-888-6726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental