Organization
CDPT II PC
Active
Other names
Children's Dental and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE V DASCH (SR. OPERATIONS COORDINATOR)
(504) 638-0303
Entity
Organization
Contact information
Practice address
17194 PRESTON RD STE 160, DALLAS, TX 75248-1221
(214) 453-2565
Mailing address
17194 PRESTON RD STE 160, DALLAS, TX 75248-1221
(214) 453-2565
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
29183
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
11/17/2017
Last updated
11/17/2017
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