Organization
OC CHILDRENS DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNAN RODRIGUEZ (OWNER)
(972) 263-1755
Entity
Organization
Contact information
Practice address
907 POLLARD ST STE 110, DALLAS, TX 75208-1728
(972) 263-1755
(972) 264-6226
Mailing address
325 W WESTCHESTER PKWY STE 100, GRAND PRAIRIE, TX 75052-2852
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/12/2020
Last updated
08/16/2021
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