Organization
ADVANTAGE DENTAL ORAL HEALTH CENTER OF TEXAS PC
Active
Other names
Advantage Dental Plus
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRIE EDMONDSON (SR MANAGER, LICENSING CREDENTIALING)
(629) 999-5014
Entity
Organization
Contact information
Practice address
8062 FERGUSON RD, DALLAS, TX 75228-5848
(214) 227-7215
Mailing address
3322 W END AVE STE 400, NASHVILLE, TN 37203-6805
(629) 999-5014
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
454521201
—
TX
Enumeration date
01/03/2023
Last updated
05/17/2023
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