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Organization
CHARISMA DENTAL
Active
Organization
CHARISMA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DULCE Y DE JESUS DDS (DENTIST)
(469) 703-8030
Entity
Organization
Contact information
Practice address
557 E US HIGHWAY 80, SUITE 130, FORNEY, TX 75126
(469) 703-8030
(469) 703-8031
Mailing address
557 E US HIGHWAY 80, SUITE 130, FORNEY, TX 75126
(469) 703-8030
(469) 703-8031
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
NULL
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
NULL
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
NULL
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
NULL
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
NULL
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
NULL
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
NULL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
1223X2210X
Orofacial Pain Dentistry
—
NULL
1223X2210X
Orofacial Pain Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
12/14/2020
Last updated
09/23/2024
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