| Professional Dental Alliance of TX 43002 PLLC | |
|
6050 Long Prairie Rd Ste 100 Flower Mound TX 75028-5613 | |
| (972) 587-0887 | |
| Not Available |
| Full Name | Professional Dental Alliance of TX 43002 PLLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6050 Long Prairie Rd Ste 100, Flower Mound, Texas |
| Authorized Official Name and Position | Lauren Howard (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7575765479 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Dental Alliance of TX 43002 PLLC 11 S Mill St New Castle PA 16101-3680 | Professional Dental Alliance of TX 43002 PLLC 6050 Long Prairie Rd Ste 100 Flower Mound TX 75028-5613 Ph: (972) 587-0887 |
| NPI Number | 1124631213 |
|---|---|
| Provider Enumeration Date | 08/28/2020 |
| Last Update Date | 08/28/2020 |
| Certification Date | 08/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124631213 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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