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3084 N Goliad St #124 Rockwall TX 75087-7163 | |
| (972) 772-4000 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3084 N Goliad St, Rockwall, Texas |
| Authorized Official Name and Position | Melina Cozby (OWNER) |
| Authorized Official Contact | 2145007833 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3084 N Goliad St #124 Rockwall TX 75087-7163 Ph: (972) 772-4000 | 3084 N Goliad St #124 Rockwall TX 75087-7163 Ph: (972) 772-4000 |
| NPI Number | 1629529672 |
|---|---|
| Provider Enumeration Date | 10/14/2016 |
| Last Update Date | 10/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629529672 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 24539 (Texas) | Primary |
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