Organization
NOMAD DENTAL SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA PETERSON (CREDENTIALING COORDINATOR)
(951) 833-2740
Entity
Organization
Contact information
Practice address
6337 TULIP LN, DALLAS, TX 75230-3829
(045) 148-1204
(833) 415-1902
Mailing address
6337 TULIP LN, DALLAS, TX 75230-3829
(404) 287-8120
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/05/2024
Last updated
03/05/2024
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