Provider Demographics
NPI:1891543021
Name:SMILE VERSE CLINIC PLLC
Entity type:Organization
Organization Name:SMILE VERSE CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR / MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANTONY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-877-7093
Mailing Address - Street 1:221 E EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-3820
Mailing Address - Country:US
Mailing Address - Phone:281-482-3331
Mailing Address - Fax:
Practice Address - Street 1:221 E EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-3820
Practice Address - Country:US
Practice Address - Phone:281-482-3331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty