| Fresh Smiles-la Grange Pllc | |
|
2001 W State Highway 71 Ste 20 La Grange TX 78945-5057 | |
| (979) 633-3111 | |
| Not Available |
| Full Name | Fresh Smiles-la Grange Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2001 W State Highway 71 Ste 20, La Grange, Texas |
| Authorized Official Name and Position | Tee Semera (CREDENTIALING) |
| Authorized Official Contact | 4695569000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Smiles-la Grange Pllc 1261 W Green Oaks Blvd Ste 101 Arlington TX 76013-8349 Ph: () - | Fresh Smiles-la Grange Pllc 2001 W State Highway 71 Ste 20 La Grange TX 78945-5057 Ph: (979) 633-3111 |
| NPI Number | 1881167484 |
|---|---|
| Provider Enumeration Date | 01/07/2019 |
| Last Update Date | 01/07/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881167484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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Fresh Smiles Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 W. St Hwy 71, Suite 20, La Grange, TX 78945 Phone: 817-451-4740 | |
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