Individual
CHI T LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3735 BELT LINE RD, ADDISON, TX 75001-4302
(972) 243-6900
(972) 243-6932
Mailing address
3735 BELT LINE RD, ADDISON, TX 75001-4302
(972) 243-6900
(972) 243-6932
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20159
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B20159
CHIPS
TX
Enumeration date
05/08/2007
Last updated
01/15/2008
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