| Grand Prairie Marvel Dental Pllc | |
|
5020 S Hwy 360 Suite 200 Grand Prairie TX 75052 | |
| (817) 933-3883 | |
| Not Available |
| Full Name | Grand Prairie Marvel Dental Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5020 S Hwy 360, Grand Prairie, Texas |
| Authorized Official Name and Position | Jay Oza (DENTIST) |
| Authorized Official Contact | 2017440760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Prairie Marvel Dental Pllc 2401 Cabrillo Ln Mansfield TX 76063-4117 Ph: () - | Grand Prairie Marvel Dental Pllc 5020 S Hwy 360 Suite 200 Grand Prairie TX 75052 Ph: (817) 933-3883 |
| NPI Number | 1629586797 |
|---|---|
| Provider Enumeration Date | 01/11/2018 |
| Last Update Date | 01/11/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629586797 | NPI | - | NPPES |
| 28081 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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