| Southern Smiles, Family & Cosmetic Dentistry | |
|
1132 Midtown Drive College Station TX 77845 | |
| (979) 846-7799 | |
| (979) 326-1510 |
| Full Name | Southern Smiles, Family & Cosmetic Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 1132 Midtown Drive, College Station, Texas |
| Authorized Official Name and Position | Patrick Stewart Burchfield (OWNER/DENTIST) |
| Authorized Official Contact | 9798467799 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Smiles, Family & Cosmetic Dentistry 1132 Midtown Drive College Station TX 77845 Ph: (979) 846-7799 | Southern Smiles, Family & Cosmetic Dentistry 1132 Midtown Drive College Station TX 77845 Ph: (979) 846-7799 |
| NPI Number | 1063957991 |
|---|---|
| Provider Enumeration Date | 01/02/2017 |
| Last Update Date | 06/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063957991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 23796 (Texas) | Primary |
| 122300000X | Dentist | 22821 (Texas) | Secondary |
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