# CAMP WISDOM ROAD DENTISTRY, PA

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

## Provider details

- **NPI number:** 1942515275
- **Authorized official:** KENNETH TO DDS (CO-PRESIDENT)
- **Authorized official phone:** (972) 642-2423

## Contact information

- **Practice address:** 319 W CAMP WISDOM RD, DUNCANVILLE, TX 75116-3332
- **Practice address phone:** (972) 642-2423
- **Practice address fax:** (972) 642-2571
- **Mailing address:** PO BOX 531649, GRAND PRAIRIE, TX 75053-1649
- **Mailing address phone:** (972) 642-2423
- **Mailing address fax:** (972) 642-2571

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 261QD0000X | Dental Clinic/Center | 24103 | TX | Yes |

## Other

- **Enumeration date:** 08/11/2010
- **Last updated:** 06/01/2026