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Organization
CAMP WISDOM ROAD DENTISTRY, PA
Active
Organization
CAMP WISDOM ROAD DENTISTRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH TO DDS (CO-PRESIDENT)
(972) 642-2423
Entity
Organization
Contact information
Practice address
319 W CAMP WISDOM RD, DUNCANVILLE, TX 75116-3332
(972) 642-2423
(972) 642-2571
Mailing address
PO BOX 531649, GRAND PRAIRIE, TX 75053-1649
(972) 642-2423
(972) 642-2571
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
Primary
24103
TX
Other
Enumeration date
08/11/2010
Last updated
06/01/2026
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