| Shepherd Lane Dental Associates,p.c | |
|
3434 Towne Crossing Blvd. Suite 106 Mesquite TX 75150-2724 | |
| (972) 279-0900 | |
| (972) 286-6106 |
| Full Name | Shepherd Lane Dental Associates,p.c |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3434 Towne Crossing Blvd., Mesquite, Texas |
| Authorized Official Name and Position | Harry J. Blanek (OWNER) |
| Authorized Official Contact | 9722790900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shepherd Lane Dental Associates,p.c 3434 Towne Crossing Blvd. Suite 106 Mesquite TX 75150-2724 Ph: (972) 286-5711 | Shepherd Lane Dental Associates,p.c 3434 Towne Crossing Blvd. Suite 106 Mesquite TX 75150-2724 Ph: (972) 279-0900 |
| NPI Number | 1073642013 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 07/18/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073642013 | NPI | - | NPPES |
| 091321202 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7005 (Texas) | Primary |
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