| Custom Dental of Denton, PLLC | |
|
4200 N I 35 Denton TX 76207-3441 | |
| (940) 591-9362 | |
| Not Available |
| Full Name | Custom Dental of Denton, PLLC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4200 N I 35, Denton, Texas |
| Authorized Official Name and Position | Shari Rene Rodgers (COO) |
| Authorized Official Contact | 4052276100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Custom Dental of Denton, PLLC 4200 N I 35 Denton TX 76207-3441 Ph: (405) 227-6100 | Custom Dental of Denton, PLLC 4200 N I 35 Denton TX 76207-3441 Ph: (940) 591-9362 |
| NPI Number | 1114654746 |
|---|---|
| Provider Enumeration Date | 08/03/2022 |
| Last Update Date | 08/03/2022 |
| Certification Date | 08/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114654746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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