Heartland Mirror Lake Dentistry Pllc

NPI #1558858704 in Heartland, Texas

Provider Information

NPI Number: 1558858704
Entity Type: Organization
Organization Name: Heartland Mirror Lake Dentistry Pllc
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Apr 13, 2018
Last Updated: Apr 13, 2018

Practice Location

Address: 2049 SUNNYBROOK DR
City: Heartland
State: Texas
ZIP Code: 75126-1270
Phone: (972) 200-4311

Authorized Official

Name: JUSTIN HUMPHRIES
Title: DIRECTOR OF OPERATIONS
Phone: (972) 200-4311

Specialties & Taxonomy Codes

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

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