| Restoration Smiles | |
|
28527 Tomball Pkwy Tomball TX 77375-4545 | |
| (832) 613-7743 | |
| (281) 907-8003 |
| Full Name | Restoration Smiles |
|---|---|
| Speciality | Dentist |
| Location | 28527 Tomball Pkwy, Tomball, Texas |
| Authorized Official Name and Position | Jennifer Mai (OWNER) |
| Authorized Official Contact | 8326137743 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restoration Smiles 28527 Tomball Pkwy Tomball TX 77375-4545 Ph: (713) 623-1122 | Restoration Smiles 28527 Tomball Pkwy Tomball TX 77375-4545 Ph: (832) 613-7743 |
| NPI Number | 1053835488 |
|---|---|
| Provider Enumeration Date | 07/27/2017 |
| Last Update Date | 02/07/2024 |
| Medicare PECOS PAC ID | 6305209586 |
|---|---|
| Medicare Enrollment ID | O20230906001347 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053835488 | NPI | - | NPPES |
| 3093486-13 | Medicaid | TX | |
| 3728164-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 28160 (Texas) | Primary |
| Provider Name | Jennifer Mai |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1669737219 PECOS PAC ID: 9032496617 Enrollment ID: I20170509000588 |
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