# JASON D ROE, DDS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pro Dental Dallas
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437887254
- **Authorized official:** DR. JASON DEREK ROE DDS (DENTIST/OWNER)
- **Authorized official phone:** (972) 931-1777

## Contact information

- **Practice address:** 5136 VILLAGE CREEK DR STE 501, PLANO, TX 75093-4460
- **Practice address phone:** (972) 931-1777
- **Mailing address:** 5136 VILLAGE CREEK DR STE 501, PLANO, TX 75093-4460
- **Mailing address phone:** (972) 931-1777

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | — | NULL | Yes |
| 1223P0700X | Prosthodontics | — | — | Yes |

## Other

- **Enumeration date:** 08/10/2022
- **Last updated:** 08/10/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 22741 | TEXAS STATE DENTAL BOARD | TX |