Organization
ORTHODONTICS FOR INFANTS AND CHILDREN
Active
Organization
ORTHODONTICS FOR INFANTS AND CHILDREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUPAKIT PEANCHITLERTKAJORN DDS, MDS (DDS)
(214) 456-8825
Entity
Organization
Contact information
Practice address
6300 HARRY HINES BLVD, DALLAS, TX 75235-5259
(214) 456-8825
(214) 456-8256
Mailing address
PO BOX 35408, DALLAS, TX 75235-0408
(214) 456-8825
(214) 456-8256
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
08/30/2006
Last updated
08/22/2020
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