Organization
JASON D ROE, DDS, PLLC
Active
Other names
Pro Dental Dallas
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON DEREK ROE DDS (DENTIST/OWNER)
(972) 931-1777
Entity
Organization
Contact information
Practice address
5136 VILLAGE CREEK DR STE 501, PLANO, TX 75093-4460
(972) 931-1777
Mailing address
5136 VILLAGE CREEK DR STE 501, PLANO, TX 75093-4460
(972) 931-1777
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22741
TEXAS STATE DENTAL BOARD
TX
Enumeration date
08/10/2022
Last updated
08/10/2022
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