Stefanus Siswanto DDS Pllc

NPI #1033385497 in Dallas, Texas

Provider Information

NPI Number: 1033385497
Entity Type: Organization
Organization Name: Stefanus Siswanto DDS Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: May 6, 2008
Last Updated: May 6, 2008

Practice Location

Address: 18181 MIDWAY RD STE 500
City: Dallas
State: Texas
ZIP Code: 75287-8104
Phone: (214) 934-2198

Authorized Official

Name: DR. STEFANUS H SISWANTO, DDS
Title: PRESIDENT
Phone: (214) 934-2198

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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