| Heartland Mirror Lake Dentistry Pllc | |
|
2049 Sunnybrook Dr Heartland TX 75126-1270 | |
| (972) 200-4311 | |
| Not Available |
| Full Name | Heartland Mirror Lake Dentistry Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2049 Sunnybrook Dr, Heartland, Texas |
| Authorized Official Name and Position | Justin Humphries (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 9722004311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartland Mirror Lake Dentistry Pllc 2049 Sunnybrook Dr Heartland TX 75126-1270 Ph: (972) 200-4311 | Heartland Mirror Lake Dentistry Pllc 2049 Sunnybrook Dr Heartland TX 75126-1270 Ph: (972) 200-4311 |
| NPI Number | 1558858704 |
|---|---|
| Provider Enumeration Date | 04/13/2018 |
| Last Update Date | 04/13/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558858704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 29699 (Texas) | Primary |