Organization
MFB DENTAL PLLC
Active
Other names
Walnut Hill Dental Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITRA BOLOURI DDS (SOLE MEMBER)
(214) 533-2689
Entity
Organization
Contact information
Practice address
8355 WALNUT HILL LN STE 130, DALLAS, TX 75231-4240
(214) 361-2208
Mailing address
8355 WALNUT HILL LN STE 130, DALLAS, TX 75231-4240
(214) 361-2208
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710242193
NPI
—
Enumeration date
12/02/2024
Last updated
12/02/2024
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