| Professional Coop | |
|
2754 W Davis Dallas TX 75211 | |
| (214) 330-4100 | |
| (214) 330-4113 |
| Full Name | Professional Coop |
|---|---|
| Speciality | Dentist |
| Location | 2754 W Davis, Dallas, Texas |
| Authorized Official Name and Position | Felix Wendall Starghill (DENTIST) |
| Authorized Official Contact | 2143304700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Coop 2754 W Davis Dallas TX 75211 Ph: (214) 330-4100 | Professional Coop 2754 W Davis Dallas TX 75211 Ph: (214) 330-4100 |
| NPI Number | 1477716447 |
|---|---|
| Provider Enumeration Date | 07/09/2008 |
| Last Update Date | 07/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477716447 | NPI | - | NPPES |
| 111291402 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 16997 (Texas) | Primary |
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