Tx Southern Dental Ppo PC

NPI #1831969302 in Colleyville, Texas

Provider Information

NPI Number
1831969302
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
Jan 5, 2024
Last Updated
Jan 5, 2024

Practice Location

Address
5005 HERITAGE AVE STE 100
State
Texas
ZIP Code
76034-5985
Phone
(682) 738-3029

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Dentist

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