Custom Dental of the Colony, Pllc
NPI #1568123719 in The Colony, Texas
Provider Information
- NPI Number
- 1568123719
- Entity Type
- Organization
- Organization Name
- Custom Dental of the Colony, Pllc
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Jan 9, 2022
- Last Updated
- Jan 9, 2022
Practice Location
- Address
- 4695 N COLONY BLVD STE 104
- City
- The Colony
- State
- Texas
- ZIP Code
- 75056-3330
- Phone
- (972) 625-0213
Authorized Official
- Name
- RENE RODGERS
- Title
- COO
- Phone
- (405) 227-6100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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