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Organization

DENTAL PROFESSIONALS OF TEXAS, P.A.

Active
Parent organization
DENTAL PROFESSIONALS OF TEXAS, P.A.
Other names
Tennyson Lake Dental
Organization subpart
Yes

Provider details

NPI number
Legal business name
DENTAL PROFESSIONALS OF TEXAS, P.A.
Authorized official
CASSANDRA PETERSEN (CREDENTIALING TEAM LEAD)
(217) 540-8972
Entity
Organization

Contact information

Practice address
5044 TENNYSON PKWY STE A, PLANO, TX 75024-2953
(972) 378-3601
Mailing address
5044 TENNYSON PKWY STE A, PLANO, TX 75024-2953

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
03/06/2018
Last updated
03/06/2018
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