Individual
TREVOR PAUL BODINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
821 N COLEMAN ST, SUITE 110, PROSPER, TX 75078-2303
(972) 741-6282
Mailing address
821 N COLEMAN ST, SUITE 110, PROSPER, TX 75078-2303
(972) 741-6282
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
27765
TX
Other
Enumeration date
01/19/2012
Last updated
04/02/2013
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