Organization
CELEBRITY DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA ELBA GARCIA-IBANCOVICHI D.D.S. (OWNER)
(214) 388-4808
Entity
Organization
Contact information
Practice address
4808 S BUCKNER BLVD, DALLAS, TX 75227-2348
(214) 388-4808
(214) 388-4100
Mailing address
4808 S BUCKNER BLVD, DALLAS, TX 75227-2348
(214) 388-4808
(214) 388-4100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
16354
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16354
—
TX
Enumeration date
07/19/2011
Last updated
07/19/2011
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