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4030 N Macarthur Blvd Suite 100 Irving TX 75038-6429 | |
| (972) 717-0077 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 4030 N Macarthur Blvd, Irving, Texas |
| Authorized Official Name and Position | Jason W Erickson (OFFICER) |
| Authorized Official Contact | 9727170077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4030 N Macarthur Blvd Suite 100 Irving TX 75038-6429 Ph: (972) 717-0077 | 4030 N Macarthur Blvd Suite 100 Irving TX 75038-6429 Ph: (972) 717-0077 |
| NPI Number | 1730339441 |
|---|---|
| Provider Enumeration Date | 09/30/2008 |
| Last Update Date | 09/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730339441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 22975 (Texas) | Primary |
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