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Organization
WILLOW TREE DENTAL, PLLC
Active
Organization
WILLOW TREE DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUPAL D BHAKTA DDS (DENTIST)
(214) 636-8434
Entity
Organization
Contact information
Practice address
1205 E DEBBIE LN, SUITE 111, MANSFIELD, TX 76063-3356
(214) 636-8434
Mailing address
1205 E DEBBIE LN, SUITE 111, MANSFIELD, TX 76063-3356
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22233
TX
Other
Enumeration date
01/26/2011
Last updated
01/26/2011
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