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Organization
VALLEY SQUARE DENTAL, PLLC
Active
Organization
VALLEY SQUARE DENTAL, PLLC
Active
Other names
Isla Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BACON DDS (OWNER)
(945) 250-0530
Entity
Organization
Contact information
Practice address
724 W MAIN ST STE 316, LEWISVILLE, TX 75067-3566
(945) 250-0530
(945) 250-0535
Mailing address
201 S ROGERS RD, IRVING, TX 75060-2608
(951) 205-5140
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/16/2023
Last updated
05/16/2023
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