Individual
KENNETH TO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
515 S CARRIER PKWY, SUITE 102, GRAND PRAIRIE, TX 75051-0921
(972) 642-2423
Mailing address
515 S CARRIER PKWY, SUITE 102, GRAND PRAIRIE, TX 75051-0921
(972) 642-2423
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
24103
TX
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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