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Organization
MAIN DENTISTRY, P.A.
Active
Organization
MAIN DENTISTRY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUJATA BASAWARAJ DMD (PRESIDENT)
(972) 370-1200
Entity
Organization
Contact information
Practice address
4679 STATE HIGHWAY 121, SUITE 109, LEWISVILLE, TX 75056-4010
(972) 370-1200
(972) 370-2679
Mailing address
4679 STATE HIGHWAY 121, SUITE 109, LEWISVILLE, TX 75056-4010
(972) 370-1200
(972) 370-2679
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
20290
TX
Other
Enumeration date
03/14/2007
Last updated
09/24/2007
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