Organization
SOUTHGLENN DENTAL CARE, PC
Active
Other names
SouthGlenn Dental Care, PC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA EISWERTH (CREDENTIALING MANAGER)
(770) 833-0994
Entity
Organization
Contact information
Practice address
6650 S VINE ST STE 200, CENTENNIAL, CO 80121-2763
(303) 797-3636
Mailing address
7160 DALLAS PKWY STE 400, PLANO, TX 75024-7111
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
Other
Enumeration date
11/30/2021
Last updated
12/07/2021
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