# KIDS DENTAL CENTER PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508233115
- **Authorized official:** DAVID M GLASS DDS (OWNER/DENTIST)
- **Authorized official phone:** (903) 831-1000

## Contact information

- **Practice address:** 908 W MAIN ST, ATLANTA, TX 75551-3430
- **Practice address phone:** (903) 831-1000
- **Mailing address:** 908 W MAIN ST, ATLANTA, TX 75551-3430

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 26442 | TX | Yes |

## Other

- **Enumeration date:** 08/31/2015
- **Last updated:** 08/31/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 282579601 | — | TX |