Organization
BRAVO DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITA NE D.D.S.,M.S. (OWNER)
(214) 704-6778
Entity
Organization
Contact information
Practice address
9202 ELAM RD, DALLAS, TX 75217-4151
(214) 704-6778
Mailing address
10333 WOODFORD DR, DALLAS, TX 75229-6316
(214) 704-6778
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18807
TX
Other
Enumeration date
02/01/2016
Last updated
02/01/2016
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