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Organization
HARVARD AVENUE DENTAL CARE PA
Active
Organization
HARVARD AVENUE DENTAL CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYLE PAUL PETRUTSAS DDS (OWNER DENTIST)
(214) 521-2258
Entity
Organization
Contact information
Practice address
3131 HARVARD AVENUE, SUITE 107, DALLAS, TX 75205
(214) 521-2258
(214) 521-3425
Mailing address
3131 HARVARD AVENUE, SUITE 107, DALLAS, TX 75205
(214) 521-2258
(214) 521-3425
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18774
TX
Other
Enumeration date
01/23/2007
Last updated
04/08/2008
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