| Healthy Smiles 4 Kids, Pc | |
|
5708 Colleyville Blvd Suite A Colleyville TX 76034-6064 | |
| (817) 428-8575 | |
| (817) 577-3970 |
| Full Name | Healthy Smiles 4 Kids, Pc |
|---|---|
| Speciality | Dentist |
| Location | 5708 Colleyville Blvd, Colleyville, Texas |
| Authorized Official Name and Position | John Ralston Gober (DENTIST/OWNER) |
| Authorized Official Contact | 8174288575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Smiles 4 Kids, Pc 5708 Colleyville Blvd Suite A Colleyville TX 76034-6064 Ph: (817) 428-8575 | Healthy Smiles 4 Kids, Pc 5708 Colleyville Blvd Suite A Colleyville TX 76034-6064 Ph: (817) 428-8575 |
| NPI Number | 1952778862 |
|---|---|
| Provider Enumeration Date | 08/26/2015 |
| Last Update Date | 08/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952778862 | NPI | - | NPPES |
| 091175203 | Medicaid | TX | |
| 091175202 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 16709 (Texas) | Primary |
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