| Community Dental Care | |
|
801 Conover Drive Grand Prairie TX 75051-1519 | |
| (214) 590-2969 | |
| (214) 266-1001 |
| Full Name | Community Dental Care |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 801 Conover Drive, Grand Prairie, Texas |
| Authorized Official Name and Position | Kevin Sutton (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2145902969 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Dental Care Po Box 532489 Grand Prairie TX 75053 Ph: (214) 590-2969 | Community Dental Care 801 Conover Drive Grand Prairie TX 75051-1519 Ph: (214) 590-2969 |
| NPI Number | 1619963485 |
|---|---|
| Provider Enumeration Date | 09/27/2005 |
| Last Update Date | 10/12/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619963485 | NPI | - | NPPES |
| 091293301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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