Provider Demographics
NPI:1427832609
Name:SMILE PROFESSIONALS
Entity type:Organization
Organization Name:SMILE PROFESSIONALS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAITHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WEHBE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:216-410-2805
Mailing Address - Street 1:4604 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3602
Mailing Address - Country:US
Mailing Address - Phone:216-410-2805
Mailing Address - Fax:
Practice Address - Street 1:19804 MORRIS AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-3708
Practice Address - Country:US
Practice Address - Phone:216-410-2805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty