Provider Demographics
NPI:1871981712
Name:MY SMILES DENTAL
Entity type:Organization
Organization Name:MY SMILES DENTAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-285-2600
Mailing Address - Street 1:2020 NORTH MASTER'S DR
Mailing Address - Street 2:100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75217
Mailing Address - Country:US
Mailing Address - Phone:972-285-2600
Mailing Address - Fax:972-285-2605
Practice Address - Street 1:2020 N MASTERS DR
Practice Address - Street 2:100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-3168
Practice Address - Country:US
Practice Address - Phone:972-285-2600
Practice Address - Fax:972-285-2605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26527122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty