| Wylie Dentistry Company | |
|
2810 W. Fm544 Suite 100 Wylie TX 75098 | |
| (800) 888-8888 | |
| Not Available |
| Full Name | Wylie Dentistry Company |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2810 W. Fm544, Wylie, Texas |
| Authorized Official Name and Position | Olufemi Fadahunsi (DENTIST/OWNER) |
| Authorized Official Contact | 4692313323 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wylie Dentistry Company 14667 Kelmscot Dr Frisco TX 75035-7291 Ph: () - | Wylie Dentistry Company 2810 W. Fm544 Suite 100 Wylie TX 75098 Ph: (800) 888-8888 |
| NPI Number | 1619465234 |
|---|---|
| Provider Enumeration Date | 04/30/2018 |
| Last Update Date | 04/30/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619465234 | NPI | - | NPPES |
| 1427497130 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS0000009689 (Tennessee) | Primary |
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