| Leaf Family Dentistry | |
|
800 S Center St Grand Prairie TX 75051-1815 | |
| (972) 264-1662 | |
| Not Available |
| Full Name | Leaf Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 800 S Center St, Grand Prairie, Texas |
| Authorized Official Name and Position | Christopher Blake Richardson (DENTIST) |
| Authorized Official Contact | 9723425371 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leaf Family Dentistry 14700 Marsh Ln Apt 921 Addison TX 75001-8060 Ph: (972) 342-5371 | Leaf Family Dentistry 800 S Center St Grand Prairie TX 75051-1815 Ph: (972) 264-1662 |
| NPI Number | 1104215425 |
|---|---|
| Provider Enumeration Date | 01/12/2015 |
| Last Update Date | 01/12/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104215425 | NPI | - | NPPES |
| 1902184476 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 27274 (Texas) | Primary |
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