Organization
ALLEN FAIZ DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALITA WATSON (RECEP/ CREDENTIALING)
(972) 231-3188
Entity
Organization
Contact information
Practice address
1311 WEST CAMPBELL RD, RICHARDSON, TX 75080
(972) 231-3188
(972) 231-3148
Mailing address
1311 W CAMPBELL RD, RICHARDSON, TX 75080-2815
(972) 231-3188
(972) 231-3148
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
18506
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090713101
—
TX
Enumeration date
05/04/2016
Last updated
05/04/2016
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