Organization
DESOTO DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAHESH BABU GONDI D.M.D. (PRESIDENT)
(972) 750-0610
Entity
Organization
Contact information
Practice address
116 W PARKERVILLE RD, STE # 112, DESOTO, TX 75115
(972) 750-0610
Mailing address
3200 PARKWOOD BLVD, #310, PLANO, TX 75093-8750
(972) 750-0610
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
22213
TX
Other
Enumeration date
10/12/2015
Last updated
02/03/2016
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