Provider Demographics
NPI:1508679432
Name:SMILE AVENUE FAMILY DENTISTRY CINCO RANCH
Entity type:Organization
Organization Name:SMILE AVENUE FAMILY DENTISTRY CINCO RANCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:VUONG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:281-394-3988
Mailing Address - Street 1:23541 WESTHEIMER PKWY STE 170
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3598
Mailing Address - Country:US
Mailing Address - Phone:281-394-3988
Mailing Address - Fax:281-394-3980
Practice Address - Street 1:23541 WESTHEIMER PKWY STE 170
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3598
Practice Address - Country:US
Practice Address - Phone:281-394-3988
Practice Address - Fax:281-394-3980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty