| Pediatric Dentistry Of Northlake Pllc | |
|
8151 Thompson Road Northlake TX 76247 | |
| (817) 706-9924 | |
| Not Available |
| Full Name | Pediatric Dentistry Of Northlake Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 8151 Thompson Road, Northlake, Texas |
| Authorized Official Name and Position | Jason Ashcroft (PRESIDENT) |
| Authorized Official Contact | 8177069924 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dentistry Of Northlake Pllc 8151 Thompson Road Northlake TX 76247 Ph: () - | Pediatric Dentistry Of Northlake Pllc 8151 Thompson Road Northlake TX 76247 Ph: (817) 706-9924 |
| NPI Number | 1386109650 |
|---|---|
| Provider Enumeration Date | 01/31/2019 |
| Last Update Date | 01/31/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386109650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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