| The Colony Pediatric & Adolescent Dentistry | |
|
2401 Little Elm Pkwy Ste 1100 Little Elm TX 75068-2076 | |
| (972) 370-9588 | |
| (972) 370-9587 |
| Full Name | The Colony Pediatric & Adolescent Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2401 Little Elm Pkwy Ste 1100, Little Elm, Texas |
| Authorized Official Name and Position | Jocelyn Yu (PEDIATRIC DENTIST/OWNER) |
| Authorized Official Contact | 9723709588 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Colony Pediatric & Adolescent Dentistry 2401 Little Elm Pkwy Ste 1100 Little Elm TX 75068-2076 Ph: (972) 370-9588 | The Colony Pediatric & Adolescent Dentistry 2401 Little Elm Pkwy Ste 1100 Little Elm TX 75068-2076 Ph: (972) 370-9588 |
| NPI Number | 1487817474 |
|---|---|
| Provider Enumeration Date | 07/09/2008 |
| Last Update Date | 04/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487817474 | NPI | - | NPPES |
| 170633501 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 21237 (Texas) | Primary |
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