| NPI | 1164390464 |
|---|---|
| Doing Business As | FANTASTIC SMILES OF HOUSTON |
| Entity Type | Organization |
| Authorized Contact | JENNY GARCIA Payer Enrollment Manager 972-869-3789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-10-28 |
| Last Update Date | 2025-10-28 |