Tx Southern Dental Ppo PC

NPI #1386401503 in Carrollton, Texas

Provider Information

NPI Number: 1386401503
Entity Type: Organization
Organization Name: Tx Southern Dental Ppo PC
Subpart: Yes (part of a larger organization)
Parent Organization: TX SOUTHERN DENTAL PPO PC
Primary Specialty: Dentist
Enumeration Date: Mar 4, 2024
Last Updated: Mar 4, 2024

Practice Location

Address: 1821 GOLDEN TRAIL CT STE 220
City: Carrollton
State: Texas
ZIP Code: 75010-4671
Phone: (972) 394-7007

Authorized Official

Name: CHRISTINE NELSON
Title: VP, REVENUE CYCLE
Phone: (469) 450-6482

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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