| Amaze Smiles, Pllc | |
|
216 Dalton Dr Desoto TX 75115-4414 | |
| (972) 230-1100 | |
| (972) 230-1103 |
| Full Name | Amaze Smiles, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 216 Dalton Dr, Desoto, Texas |
| Authorized Official Name and Position | Suzanne Najjar (OWNER) |
| Authorized Official Contact | 9722301100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amaze Smiles, Pllc 216 Dalton Dr Desoto TX 75115-4414 Ph: (972) 230-1100 | Amaze Smiles, Pllc 216 Dalton Dr Desoto TX 75115-4414 Ph: (972) 230-1100 |
| NPI Number | 1982165148 |
|---|---|
| Provider Enumeration Date | 03/28/2019 |
| Last Update Date | 03/28/2019 |
| Medicare PECOS PAC ID | 8123351483 |
|---|---|
| Medicare Enrollment ID | O20190531001886 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982165148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Suzanne Najjar |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1720532187 PECOS PAC ID: 2567795826 Enrollment ID: I20190531002012 |
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