| Providence Dental Health & Wellness Center | |
|
2701 Osler Dr Ste 10 Grand Prairie TX 75051-1064 | |
| (972) 641-2400 | |
| Not Available |
| Full Name | Providence Dental Health & Wellness Center |
|---|---|
| Speciality | Dentist |
| Location | 2701 Osler Dr, Grand Prairie, Texas |
| Authorized Official Name and Position | Latonia Smith (OWNER) |
| Authorized Official Contact | 9726412400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Dental Health & Wellness Center 2701 Osler Dr Ste 10 Grand Prairie TX 75051-1064 Ph: () - | Providence Dental Health & Wellness Center 2701 Osler Dr Ste 10 Grand Prairie TX 75051-1064 Ph: (972) 641-2400 |
| NPI Number | 1548509508 |
|---|---|
| Provider Enumeration Date | 02/11/2013 |
| Last Update Date | 02/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548509508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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