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Individual

DEJI V. FASHEMO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS, MPH

Contact information

Practice address
7777 FOREST LN, SUITE # C-770, DALLAS, TX 75230-2505
(972) 566-3100
(972) 566-3200
Mailing address
7777 FOREST LN, SUITE # C-770, DALLAS, TX 75230-2505
(972) 566-3100
(972) 566-3200

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
21639
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
171860301
TX
Enumeration date
05/18/2006
Last updated
11/10/2009
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