Individual
CALEB MANGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4685 ELDORADO PKWY STE 200, FRISCO, TX 75033-0290
(214) 618-5450
Mailing address
17712 RIVER CHASE DR, DALLAS, TX 75287-6265
(505) 301-4473
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
34039
TX
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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