Organization
GRAND PRAIRIE MODERN DENTISTRY, PC
Active
Other names
Grand Prairie Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY L ROBERTS DMD (OWNER)
(469) 701-2344
Entity
Organization
Contact information
Practice address
1215 ARKANSAS LN STE 100, GRAND PRAIRIE, TX 75052-7276
(469) 701-2344
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8890
(949) 474-1495
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/11/2019
Last updated
04/13/2022
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