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Organization

DALLAS ENDODONTICS, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LORI WILLIS (ADMINISTRATIVE ASST.)
(972) 644-1162
Entity
Organization

Contact information

Practice address
11910 GREENVILLE AVE, SUITE 450, DALLAS, TX 75243-3596
(972) 644-1162
(972) 783-6660
Mailing address
11910 GREENVILLE AVE, SUITE 450, DALLAS, TX 75243-3596
(972) 644-1162
(972) 783-6660

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
10924
TX
1223E0200X
Endodontics
16886
TX
1223E0200X
Endodontics
Primary
19484
TX

Other

Enumeration date
01/08/2007
Last updated
01/25/2016
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