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Organization
PLANO DENTAL IMAGING, PLLC
Active
Organization
PLANO DENTAL IMAGING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM M BOLAK DMD (MANAGER)
(972) 612-7100
Entity
Organization
Contact information
Practice address
5509 PLEASANT VALLEY DR, SUITE 700, PLANO, TX 75023
(972) 612-7100
(972) 499-2420
Mailing address
910 PRESIDIO CT, ALLEN, TX 75013
(972) 612-7100
(972) 499-2420
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17551
TX
1223X0008X
Oral and Maxillofacial Radiology Dentistry
17551
TX
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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