Organization
DENTAL PROVIDER RESOURCES, PLLC
Active
Other names
Radiant Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
JARED BRUGGEMAN DDS (OWNER)
(817) 328-6150
Entity
Organization
Contact information
Practice address
1800 BRINKER RD, STE 290, DENTON, TX 76208-6176
(940) 382-1282
(940) 566-2495
Mailing address
1000 TEXAN TRL, STE 229, GRAPEVINE, TX 76051-3776
(817) 328-6150
(866) 882-1702
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/21/2012
Last updated
05/21/2012
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