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Organization
NORTHEAST DALLAS DENTAL ASSOCIATES, PLLC
Active
Organization
NORTHEAST DALLAS DENTAL ASSOCIATES, PLLC
Active
Other names
Pine Cove Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEVY T DO DDS (PRESIDENT)
(405) 633-3396
Entity
Organization
Contact information
Practice address
1560 E DEBBIE LN STE 108, MANSFIELD, TX 76063-8575
(817) 453-8520
Mailing address
1560 E DEBBIE LN STE 108, MANSFIELD, TX 76063-8575
(817) 453-8520
(817) 453-8522
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
28984
TX
Other
Enumeration date
01/18/2016
Last updated
01/23/2018
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