| Cantrell Family Dentistry | |
|
465 Country Club Rd 104 Wylie TX 75098-7136 | |
| (972) 442-9139 | |
| (972) 442-9061 |
| Full Name | Cantrell Family Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 465 Country Club Rd, Wylie, Texas |
| Authorized Official Name and Position | Jonathan Cantrell (MEMBER) |
| Authorized Official Contact | 9724429139 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cantrell Family Dentistry 456 Country Club Rd 104 Wylie TX 75098 Ph: (972) 442-9139 | Cantrell Family Dentistry 465 Country Club Rd 104 Wylie TX 75098-7136 Ph: (972) 442-9139 |
| NPI Number | 1447682547 |
|---|---|
| Provider Enumeration Date | 07/31/2013 |
| Last Update Date | 07/31/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447682547 | NPI | - | NPPES |
| 1114187895 | Other | TX | INDIVIDUAL NPI- SARAH CANTRELL DDS |
| 1538424163 | Other | TX | INDIVIDUAL NPI- JONATHAN CANTRELL DDS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 28065 (Texas) | Primary |
| 261QD0000X | Clinic/center - Dental | 23948 (Texas) | Secondary |
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