| Mrs Dental, Pllc | |
|
1100 E Southlake Blvd Ste 600 Southlake TX 76092-6355 | |
| (817) 442-6200 | |
| Not Available |
| Full Name | Mrs Dental, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1100 E Southlake Blvd Ste 600, Southlake, Texas |
| Authorized Official Name and Position | Rohen Sukkawala (VICE PRESIDENT) |
| Authorized Official Contact | 9795870466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Dental, Pllc 1100 E Southlake Blvd Ste 600 Southlake TX 76092-6355 Ph: (817) 442-6200 | Mrs Dental, Pllc 1100 E Southlake Blvd Ste 600 Southlake TX 76092-6355 Ph: (817) 442-6200 |
| NPI Number | 1821963117 |
|---|---|
| Provider Enumeration Date | 10/07/2025 |
| Last Update Date | 10/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821963117 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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