| Mydentist-lewisville Perio | |
|
930 W Main St Lewisville TX 75067-3516 | |
| (469) 464-3850 | |
| Not Available |
| Full Name | Mydentist-lewisville Perio |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 930 W Main St, Lewisville, Texas |
| Authorized Official Name and Position | Kendra Walker (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175408312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mydentist-lewisville Perio 930 W Main St Lewisville TX 75067-3516 | Mydentist-lewisville Perio 930 W Main St Lewisville TX 75067-3516 Ph: (469) 464-3850 |
| NPI Number | 1871913293 |
|---|---|
| Provider Enumeration Date | 04/24/2014 |
| Last Update Date | 04/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871913293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | () | Primary |
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