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4011 E. Renner Road Suite #107 Richardson TX 75082-2917 | |
| (972) 238-5665 | |
| (972) 238-5765 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4011 E. Renner Road, Richardson, Texas |
| Authorized Official Name and Position | Jeffrey W Moore (PRESIDENT) |
| Authorized Official Contact | 9722385665 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4011 E. Renner Road Suite #107 Richardson TX 75082-2917 Ph: (972) 238-5665 | 4011 E. Renner Road Suite #107 Richardson TX 75082-2917 Ph: (972) 238-5665 |
| NPI Number | 1003901661 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003901661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 14959 (Texas) | Primary |
Richardson Oral Surgery And Implant Center Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1070 W Campbell Rd, Suite 200, Richardson, TX 75080 Phone: 972-231-6661 Fax: 972-231-3161 | |
Jay L. Nutt & C. Fred Pietsch, Dds, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1231 E Belt Line Rd, Suite 103, Richardson, TX 75081 Phone: 972-690-8617 Fax: 972-690-6423 | |