| Prodigious Dental Pc | |
|
664 Sw Wilshire Blvd Burleson TX 76028-5851 | |
| (801) 440-2246 | |
| Not Available |
| Full Name | Prodigious Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 664 Sw Wilshire Blvd, Burleson, Texas |
| Authorized Official Name and Position | Arshdeep Sohi (PRESIDENT) |
| Authorized Official Contact | 8174263331 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prodigious Dental Pc 664 Sw Wilshire Blvd Burleson TX 76028-5851 Ph: (801) 440-2246 | Prodigious Dental Pc 664 Sw Wilshire Blvd Burleson TX 76028-5851 Ph: (801) 440-2246 |
| NPI Number | 1124593066 |
|---|---|
| Provider Enumeration Date | 10/08/2018 |
| Last Update Date | 12/28/2021 |
| Medicare PECOS PAC ID | 9638617418 |
|---|---|
| Medicare Enrollment ID | O20240812001317 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124593066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Arshdeep Sohi |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1235537572 PECOS PAC ID: 0547708323 Enrollment ID: I20240812001913 |
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