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Organization

MAGNOLIA PARK DENTAL, PLLC

Active
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Organization

MAGNOLIA PARK DENTAL, PLLC

Active
Other names
Magnolia Park Dental
Organization subpart
No

Provider details

NPI number
Authorized official
BRADY JONATHAN CAMP DDS (OWNER)
(972) 899-4900
Entity
Organization

Contact information

Practice address
651 N DENTON TAP RD, SUITE 170, COPPELL, TX 75019-2007
(972) 899-4900
(972) 899-4928
Mailing address
651 N DENTON TAP RD, SUITE 170, COPPELL, TX 75019-2007
(972) 899-4900
(972) 899-4928

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23238
TX

Other

Enumeration date
04/13/2012
Last updated
04/13/2012
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