Provider Demographics
NPI:1588969893
Name:HAPPY TEETH DENTAL CENTERS OF DALLAS PC
Entity type:Organization
Organization Name:HAPPY TEETH DENTAL CENTERS OF DALLAS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NINA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOLAYEM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-285-2600
Mailing Address - Street 1:2020 N MASTERS DR SUITE #100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75217
Mailing Address - Country:US
Mailing Address - Phone:972-285-2600
Mailing Address - Fax:817-531-0431
Practice Address - Street 1:2020 N MASTERS DR SUITE #100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217
Practice Address - Country:US
Practice Address - Phone:972-285-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247161223G0001X
TX251561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty