Park Cities Family Dentistry, PA
Preferred Provider Organization in Dallas, TX. Organization (NPI-2).
NPI number1457790933
StatusActive
Last updated in NPPESJun 18, 2013
Details
- NPI
- 1457790933
- Entity type
- Organization (NPI-2)
- Legal business name
- Park Cities Family Dentistry, PA
- Organization subpart
- No
- Enumeration date
- Jun 18, 2013
- Last updated
- Jun 18, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305R00000X | Preferred Provider Organization | 15507 | TX | Yes |
Practice location
3100 Monticello AveSuite 110
Dallas, TX 75205-3442
Phone 214-528-3770 · Fax 214-526-7436
Mailing address
3100 Monticello AveSuite 110
Dallas, TX 75205-3442
Phone 214-528-3770 · Fax 214-526-7436
Authorized official
Jeffrey W Hubbard
President
2145283770
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