| Supakit | |
|
6300 Harry Hines Blvd Suite 600 Dallas TX 75235-5259 | |
| (214) 456-8825 | |
| (214) 456-8256 |
| Full Name | Supakit |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 6300 Harry Hines Blvd, Dallas, Texas |
| Authorized Official Name and Position | Supakit Peanchitlertkajorn (OWNER) |
| Authorized Official Contact | 2144568825 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Supakit Po Box 35408 Dallas TX 75235-0408 Ph: (214) 456-8825 | Supakit 6300 Harry Hines Blvd Suite 600 Dallas TX 75235-5259 Ph: (214) 456-8825 |
| NPI Number | 1376652248 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376652248 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 21159 (Texas) | Primary |
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