Organization
CASA ALTA VISTA DENTAL, PA
Active
Other names
Bear Creek Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ROERT TAFEL DDS (OWNER)
(214) 420-7000
Entity
Organization
Contact information
Practice address
3045 N BUCKNER BLVD STE 100, DALLAS, TX 75228-5292
(214) 420-7000
Mailing address
PO BOX 543471, DALLAS, TX 75354-3471
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
05/26/2023
Last updated
05/26/2023
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