Organization
DENTAL DELITE OF DUNCANVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE BOHANNAN (OFFICE MANAGER)
(972) 572-5990
Entity
Organization
Contact information
Practice address
938 E HIGHWAY 67, DUNCANVILLE, TX 75137-2706
(972) 572-5990
(972) 572-5994
Mailing address
938 E HIGHWAY 67, DUNCANVILLE, TX 75137-2706
(972) 572-5990
(972) 572-5994
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13654
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090281902
—
TX
Enumeration date
05/21/2008
Last updated
03/11/2013
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