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Organization
GRAPEVINE KIDS PLLC
Active
Organization
GRAPEVINE KIDS PLLC
Active
Other names
Grapevine Kids Dental and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYLE MATTHEW SCHOFIELD DDS (MANAGING MEMBER)
(469) 900-5371
Entity
Organization
Contact information
Practice address
1230 S MAIN ST, GRAPEVINE, TX 76051-5544
(972) 258-0758
Mailing address
1230 S MAIN ST, GRAPEVINE, TX 76051-5544
(817) 909-2920
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
07/05/2019
Last updated
03/06/2024
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