Individual
CARLOS SEVILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3302 GASTON AVE, DALLAS, TX 75246-2013
(214) 245-9409
Mailing address
5657 AMESBURY DR APT 1912, DALLAS, TX 75206-3077
(214) 245-9409
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
29240
TX
Other
Enumeration date
02/04/2014
Last updated
02/04/2014
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