Organization
DC SOUTHERN DENTAL PPO PC
Active
Parent organization
DC SOUTHERN DENTAL PPO PC
Other names
Phillips, Cooper & Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
DC SOUTHERN DENTAL PPO PC
Authorized official
ERIKA MENJIVAR (SR. CREDENTIALING SPECIALIST)
(469) 596-6137
Entity
Organization
Contact information
Practice address
1625 K ST NW # LL, WASHINGTON, DC 20006-1604
(202) 463-2090
Mailing address
5830 GRANITE PKWY STE 780M, PLANO, TX 75024-6775
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
—
—
Other
Enumeration date
01/30/2025
Last updated
01/30/2025
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