# DALLAS ENDODONTICS, P.A.

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

## Provider details

- **NPI number:** 1902954472
- **Authorized official:** LORI WILLIS (ADMINISTRATIVE ASST.)
- **Authorized official phone:** (972) 644-1162

## Contact information

- **Practice address:** 11910 GREENVILLE AVE, SUITE 450, DALLAS, TX 75243-3596
- **Practice address phone:** (972) 644-1162
- **Practice address fax:** (972) 783-6660
- **Mailing address:** 11910 GREENVILLE AVE, SUITE 450, DALLAS, TX 75243-3596
- **Mailing address phone:** (972) 644-1162
- **Mailing address fax:** (972) 783-6660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 10924 | TX | — |
| 1223E0200X | Endodontics | 16886 | TX | — |
| 1223E0200X | Endodontics | 19484 | TX | Yes |

## Other

- **Enumeration date:** 01/08/2007
- **Last updated:** 01/25/2016