Organization
PEDIATRIC DENTAL CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA LIGHTFOOT (AUTHORIZED REPRESENTATIVE)
(214) 702-0708
Entity
Organization
Contact information
Practice address
1300 CROP CIR, YUKON, OK 73099-4945
(214) 702-0729
Mailing address
15660 DALLAS PKWY STE 950, DALLAS, TX 75248-3309
(214) 702-0729
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
06/17/2019
Last updated
01/28/2026
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