| Tennyson Lake Dental | |
|
5044 Tennyson Pkwy Ste A Plano TX 75024-2953 | |
| (972) 378-3601 | |
| Not Available |
| Full Name | Tennyson Lake Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5044 Tennyson Pkwy Ste A, Plano, Texas |
| Authorized Official Name and Position | Cassandra Petersen (CREDENTIALING TEAM LEAD) |
| Authorized Official Contact | 2175408972 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tennyson Lake Dental 5044 Tennyson Pkwy Ste A Plano TX 75024-2953 Ph: () - | Tennyson Lake Dental 5044 Tennyson Pkwy Ste A Plano TX 75024-2953 Ph: (972) 378-3601 |
| NPI Number | 1043712037 |
|---|---|
| Provider Enumeration Date | 03/06/2018 |
| Last Update Date | 03/06/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043712037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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