# DANTAM DENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SHINESTAR DENTAL CARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942996012
- **Authorized official:** DR. SOWJANYA BASIREDDYGARI DMD (PRESIDENT/DENTIST)
- **Authorized official phone:** (703) 869-1428

## Contact information

- **Practice address:** 15801 ROLATER RD, SUITE 202, FRISCO, TX 75035
- **Practice address phone:** (469) 353-6886
- **Practice address fax:** (469) 353-6883
- **Mailing address:** 10914 MANUEL ST, FRISCO, TX 75035-1435
- **Mailing address phone:** (703) 869-1428

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 04/12/2023
- **Last updated:** 04/12/2023