Great Expression Smiles

LBN: Great Expression Smiles
Great Expression Smiles is an health care organization with primary practice located at 6426 Meadowbrook Dr , Fort Worth TX 76112-5123. The organization recently has only one registered license in Managed Care Organizations / Preferred Provider Organization, which is considered as the primary health care specialty. Great Expression Smiles can be contacted via phone (817) 496-2343, or through Pham, Tri via phone (817) 496-2343.

Contact Information

Primary practice address
6426 Meadowbrook Dr Fort Worth TX 76112-5123
Phone: (817) 496-2343
Fax: (817) 665-3822
Website:
Map and Directions
Authorized official contact:
Name: Pham, Tri Doctor of Dental Surgery (DDS)
Phone: (817) 496-2343

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Preferred Provider Organization 305R00000X

Profile Details

NPI number 1568873677
LBN Legal business name Great Expression Smiles
DBA Doing business as Great Expression Smiles
Authorized official Pham, Tri Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date May 12th, 2014
Last updated May 12th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568873677 NPPES
Texas MEDICAID 202009121

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