Richardspn Dental Professionals
Preferred Provider Organization in Richardson, TX. Organization (NPI-2).
NPI number1306232764
StatusActive
Last updated in NPPESApr 13, 2015
Details
- NPI
- 1306232764
- Entity type
- Organization (NPI-2)
- Legal business name
- Richardspn Dental Professionals
- Organization subpart
- No
- Enumeration date
- Apr 13, 2015
- Last updated
- Apr 13, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305R00000X | Preferred Provider Organization | 11808 | TX | Yes |
Other names
- Richardson Cosmetic Dentistry (Doing Business As)
Practice location
700 E Campbell RdSte. #240
Richardson, TX 75081-2041
Phone 972-690-6653 · Fax 972-680-8757
Mailing address
700 E Campbell RdSte. #240
Richardson, TX 75081-2041
Phone 972-690-6653 · Fax 972-680-8757
Authorized official
Kerry Maxwell Goad
General Dentist
9726906653
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All 5 Preferred Provider Organization providers in Richardson · All 4,324 providers in Richardson
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