| Southridge Dental, Llc | |
|
3303 Unicorn Lake Blvd Ste 200 Denton TX 76210 | |
| (940) 566-4942 | |
| (940) 381-0815 |
| Full Name | Southridge Dental, Llc |
|---|---|
| Speciality | Dentist |
| Location | 3303 Unicorn Lake Blvd, Denton, Texas |
| Authorized Official Name and Position | Tyrone Dunson (OWNER/DENTIST) |
| Authorized Official Contact | 9405664942 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southridge Dental, Llc 3303 Unicorn Lake Blvd Ste 200 Denton TX 76210 Ph: (940) 566-4942 | Southridge Dental, Llc 3303 Unicorn Lake Blvd Ste 200 Denton TX 76210 Ph: (940) 566-4942 |
| NPI Number | 1740709344 |
|---|---|
| Provider Enumeration Date | 09/14/2017 |
| Last Update Date | 09/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740709344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 18977 (Texas) | Primary |
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