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Organization

VINTAGE DENTAL SPA PLLC

Active
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Organization

VINTAGE DENTAL SPA PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLIE F. CARMICHAEL III DDS (OWNER)
(214) 705-7272
Entity
Organization

Contact information

Practice address
4245 N CENTRAL EXPY, SUITE 240, DALLAS, TX 75205-4581
(214) 520-0887
Mailing address
4245 N CENTRAL EXPY, SUITE 240, DALLAS, TX 75205-4581

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22973
TX

Other

Enumeration date
12/17/2010
Last updated
03/10/2011
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