Willow Tree Dental, Pllc

NPI #1124324991 in Mansfield, Texas

Provider Information

NPI Number: 1124324991
Entity Type: Organization
Organization Name: Willow Tree Dental, Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 26, 2011
Last Updated: Jan 26, 2011

Practice Location

Address: 1205 E DEBBIE LN
Address 2: SUITE 111
City: Mansfield
State: Texas
ZIP Code: 76063-3356
Phone: (214) 636-8434

Authorized Official

Name: DR. RUPAL D BHAKTA, DDS
Title: DENTIST
Phone: (214) 636-8434

Specialties & Taxonomy Codes

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

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