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Organization

DENTAL COLUMBIA, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IHNBAE CHO (DDS)
(520) 906-5765
Entity
Organization

Contact information

Practice address
5004 COLUMBIA AVE STE 101, DALLAS, TX 75214-5542
(469) 809-8618
Mailing address
5004 COLUMBIA AVE STE 101, DALLAS, TX 75214-5542

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
08/02/2022
Last updated
08/02/2022
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