Organization
DENTAL HEALTH PROFESSIONALS
Active
Other names
The Addison Dentist
Organization subpart
No
Provider details
NPI number
Authorized official
AMY KROEGER (INS COOD)
(217) 540-5100
Entity
Organization
Contact information
Practice address
5304 BELT LINE RD, DALLAS, TX 75254-7606
(972) 233-0973
(972) 233-0985
Mailing address
5304 BELT LINE RD, DALLAS, TX 75254-7606
(972) 233-0973
(972) 233-0985
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/08/2007
Last updated
08/22/2020
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