Purely Dental Group Pllc S-Corp

NPI #1073940011 in Royse City, Texas

Provider Information

NPI Number: 1073940011
Entity Type: Organization
Organization Name: Purely Dental Group Pllc S-Corp
Primary Specialty: Dentist
Enumeration Date: Oct 5, 2013
Last Updated: Oct 5, 2013

Practice Location

Address: 7406 STATE HIGHWAY 66
City: Royse City
State: Texas
ZIP Code: 75189
Phone: (972) 460-4422

Authorized Official

Name: DR. ANDY DAVONG, D.D.S.
Title: PRESIDENT
Phone: (972) 804-5624

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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