Organization
SARAH CANTRELL DDS PLLC
Active
Other names
Cantrell Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN CANTRELL D.D.S. (MEMBER)
(972) 442-9139
Entity
Organization
Contact information
Practice address
465 COUNTRY CLUB RD, 104, WYLIE, TX 75098-7136
(972) 442-9139
(972) 442-9061
Mailing address
456 COUNTRY CLUB RD, 104, WYLIE, TX 75098
(972) 442-9139
(972) 442-9061
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
23948
TX
261QD0000X
Dental Clinic/Center
Primary
28065
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114187895
INDIVIDUAL NPI- SARAH CANTRELL DDS
TX
01
—
1538424163
INDIVIDUAL NPI- JONATHAN CANTRELL DDS
TX
Enumeration date
07/31/2013
Last updated
07/31/2013
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