| Sugarland Smile Center Pllc | |
|
17101 W Grand Pkwy S Sugar Land TX 77479-4984 | |
| (832) 202-9153 | |
| Not Available |
| Full Name | Sugarland Smile Center Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 17101 W Grand Pkwy S, Sugar Land, Texas |
| Authorized Official Name and Position | Ashok K Kota (CEO) |
| Authorized Official Contact | 8322029153 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sugarland Smile Center Pllc 3811 Pearl Lake Ln Sugar Land TX 77479-4883 Ph: (832) 202-9153 | Sugarland Smile Center Pllc 17101 W Grand Pkwy S Sugar Land TX 77479-4984 Ph: (832) 202-9153 |
| NPI Number | 1396365177 |
|---|---|
| Provider Enumeration Date | 04/21/2020 |
| Last Update Date | 02/22/2024 |
| Medicare PECOS PAC ID | 4789028333 |
|---|---|
| Medicare Enrollment ID | O20240222000767 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396365177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Ashok K Kota |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1386701290 PECOS PAC ID: 7911941257 Enrollment ID: I20240222000959 |
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