| Harvard Avenue Dental Care Pa | |
|
3131 Harvard Avenue Suite 107 Dallas TX 75205 | |
| (214) 521-2258 | |
| (214) 521-3425 |
| Full Name | Harvard Avenue Dental Care Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3131 Harvard Avenue, Dallas, Texas |
| Authorized Official Name and Position | Lyle Paul Petrutsas (OWNER DENTIST) |
| Authorized Official Contact | 2145212258 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harvard Avenue Dental Care Pa 3131 Harvard Avenue Suite 107 Dallas TX 75205 Ph: (214) 521-2258 | Harvard Avenue Dental Care Pa 3131 Harvard Avenue Suite 107 Dallas TX 75205 Ph: (214) 521-2258 |
| NPI Number | 1659425759 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 04/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659425759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 18774 (Texas) | Primary |
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