| Dental Avenue, P.a. | |
|
300 S Cottonwood Dr Suite #f Richardson TX 75080-5751 | |
| (214) 703-0044 | |
| (214) 703-0691 |
| Full Name | Dental Avenue, P.a. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 300 S Cottonwood Dr, Richardson, Texas |
| Authorized Official Name and Position | Emily Soo (PRESIDENT) |
| Authorized Official Contact | 2147030044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Avenue, P.a. 300 S Cottonwood Dr Suite #f Richardson TX 75080-5751 Ph: (214) 703-0044 | Dental Avenue, P.a. 300 S Cottonwood Dr Suite #f Richardson TX 75080-5751 Ph: (214) 703-0044 |
| NPI Number | 1750488748 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 01/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750488748 | NPI | - | NPPES |
| 1702086 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 21145 (Texas) | Primary |
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