Affordable Dentist Near Me Grand Prairie, PLLC
Dentist, General Practice in Grand Prairie, TX. Organization (NPI-2).
NPI number1134737919
StatusActive
Last updated in NPPESFeb 2, 2021
Details
- NPI
- 1134737919
- Entity type
- Organization (NPI-2)
- Legal business name
- Affordable Dentist Near Me Grand Prairie, PLLC
- Organization subpart
- No
- Enumeration date
- Jul 17, 2020
- Certification date
- Feb 2, 2021
- Last updated
- Feb 2, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Affordable Dentist Near Me (Doing Business As)
Practice location
2501 W Interstate 20 Ste 100Grand Prairie, TX 75052-3948
Phone 817-496-2389
Mailing address
5416 Basswood BlvdFort Worth, TX 76137-4400
Phone 817-656-1215
Authorized official
Nina Bartolomei
Manager
8178106239
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