Tx Southern Dental Ppo PC

NPI #1912777483 in Arlington, Texas

Provider Information

NPI Number: 1912777483
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: 5501 MATLOCK RD
City: Arlington
State: Texas
ZIP Code: 76018-1534
Phone: (817) 468-3322

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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