SE Professional

NPI #1174934236 in Frisco, Texas

Provider Information

NPI Number: 1174934236
Entity Type: Organization
Organization Name: SE Professional
Primary Specialty: Dentist - General Practice
Enumeration Date: May 12, 2014
Last Updated: May 12, 2014

Practice Location

Address: 5858 W MAIN ST
City: Frisco
State: Texas
ZIP Code: 75033-4193
Phone: (972) 377-4477

Authorized Official

Name: DR. JARED BRUGGEMAN
Title: DENTIST
Phone: (817) 912-2982

Specialties & Taxonomy Codes

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

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