| Duncanville Dental Pllc | |
|
5409 N Jim Miller Rd Ste 105 Dallas TX 75227-1500 | |
| (214) 865-8319 | |
| Not Available |
| Full Name | Duncanville Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 5409 N Jim Miller Rd Ste 105, Dallas, Texas |
| Authorized Official Name and Position | Cecilia Simmons (OWNER) |
| Authorized Official Contact | 2148658319 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Duncanville Dental Pllc 6524 Prairie Flower Trl Dallas TX 75227-2803 Ph: (214) 298-4656 | Duncanville Dental Pllc 5409 N Jim Miller Rd Ste 105 Dallas TX 75227-1500 Ph: (214) 865-8319 |
| NPI Number | 1992323257 |
|---|---|
| Provider Enumeration Date | 07/13/2020 |
| Last Update Date | 09/02/2020 |
| Medicare PECOS PAC ID | 6709203912 |
|---|---|
| Medicare Enrollment ID | O20200902002939 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992323257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| Provider Name | Cecilia Freeney Simmons |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1508144510 PECOS PAC ID: 9335566546 Enrollment ID: I20200902003054 |
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