Organization
CHAMPION DENTAL
Active
Other names
Champion Dental
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING MANAGER)
(612) 859-0444
Entity
Organization
Contact information
Practice address
2936 VALLEY VIEW LN, FARMERS BRANCH, TX 75234-4929
(214) 945-7334
Mailing address
2936 VALLEY VIEW LN, FARMERS BRANCH, TX 75234-4929
(214) 945-7334
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/16/2019
Last updated
10/16/2019
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