Provider Demographics
NPI:1902544471
Name:YELLOW CITY SMILES PLLC
Entity Type:Organization
Organization Name:YELLOW CITY SMILES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-377-7050
Mailing Address - Street 1:7200 SW 45TH AVE UNIT 5
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-5084
Mailing Address - Country:US
Mailing Address - Phone:806-677-0202
Mailing Address - Fax:806-677-0205
Practice Address - Street 1:7200 SW 45TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-5025
Practice Address - Country:US
Practice Address - Phone:806-677-0202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental