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Pediatric Dentristry of Mansfield,pllc

NPI #1508133224 in Mansfield, Texas

Provider Information

NPI Number
1508133224
Entity Type
Organization
Organization Name
Pediatric Dentristry of Mansfield,pllc
Primary Specialty
Dentist - Pediatric Dentistry
Enumeration Date
Nov 23, 2011
Last Updated
Dec 30, 2014

Practice Location

Address
1830 E BROAD ST
Address 2
STE104
City
Mansfield
State
Texas
ZIP Code
76063-9162
Phone
(817) 473-7171

Authorized Official

Name
DEBORAH C. SULLIVAN, DDS, MS PC
Title
OWNER
Phone
(817) 473-7171

Specialties & Taxonomy Codes

Specialty
Dentist - Pediatric Dentistry — Pediatric Dentistry

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