Heath Mirror Lake Dentistry Pllc

NPI #1427545516 in Heath, Texas

Provider Information

NPI Number: 1427545516
Entity Type: Organization
Organization Name: Heath Mirror Lake Dentistry Pllc
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Apr 16, 2018
Last Updated: Apr 16, 2018

Practice Location

Address: 4225 RIDGE RD
City: Heath
State: Texas
ZIP Code: 75032-5833
Phone: (972) 287-5513

Authorized Official

Name: JUSTIN HUMPHRIES
Title: DIRECTOR OF OPERATIONS
Phone: (972) 287-5513

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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