Individual
MICHAEL OPPEDISANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5421 RICHARD AVE, DALLAS, TX 75206-6713
(214) 228-1415
Mailing address
5421 RICHARD AVE, DALLAS, TX 75206-6713
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
23102
TX
1223P0221X
Pediatric Dentistry
Primary
23102
TX
1223P0700X
Prosthodontics
23102
TX
Other
Enumeration date
05/01/2008
Last updated
02/17/2012
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