Organization
DNA DENTAL ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL D TAYLOR III DDS (OWNER / DENTIST)
(469) 272-6792
Entity
Organization
Contact information
Practice address
610 UPTOWN BLVD STE 3100, CEDAR HILL, TX 75104-3535
(469) 272-6792
Mailing address
610 UPTOWN BLVD STE 3100, CEDAR HILL, TX 75104-3535
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124387683
INDIVIDUAL NPI
—
Enumeration date
07/28/2021
Last updated
07/28/2021
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