Organization
PECAN TREE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QUINN JOE SMITH D.M.D. (OWNER)
(208) 371-2007
Entity
Organization
Contact information
Practice address
775 W WESTCHESTER PKWY STE 101, GRAND PRAIRIE, TX 75052-2851
(972) 262-5111
Mailing address
2672 BASSWOOD DR, GRAND PRAIRIE, TX 75052-4700
(602) 300-1059
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
30205
TX
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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